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Background: Entrepreneurial attitudes among nursing students are crucial for fostering innovation and addressing the evolving challenges in healthcare. However, measuring these attitudes accurately requires robust and validated instruments. The Nursing Start-up Attitude Scale is a valid and reliable instrument specifically designed to measure nursing students' attitudes towards start-ups. However, its psychometric properties in the context of the Iranian nursing field have not been thoroughly examined.

Methods: This methodological study was conducted online between 2021 and 2023, involving nursing students from various universities across Iran. The study employed the following procedures: forward-backward translation, assessment of face and content validities, concurrent validity analysis (n = 80 nursing students), exploratory factor analysis (n = 120), confirmatory factor analysis (n = 220), and reliability analysis, which included the assessment of Cronbach's alpha coefficient, interclass correlation coefficient, interpretability, and ceiling and floor effects.

Results: A total of 370 nursing students participated in the study. After ensuring the face and content validities, the concurrent validity was confirmed (r = 0.89). The five factors extracted in the exploratory factor analysis, which accounted for 80.74% of the explained variance, were subsequently confirmed in the confirmatory factor analysis. The Cronbach's alpha coefficient was found to be 0.85. Additionally, the interclass correlation coefficient for the total scale was 0.812, and there were no ceiling or floor effects observed (0%).

Conclusion: The present study confirms the validity and reliability of the Nursing Start-up Attitude Scale in the Iranian context. This scale can serve as a valuable tool for identifying both the strengths and areas for improvement in nursing entrepreneurial education programs. By utilizing the Nursing Start-up Attitude Scale, these programs can effectively enhance the development of entrepreneurial skills among future nursing professionals.

Background: Long-term care insurance (LTCI) projects were an essential components of health systems designed to support disabled people and their families. Despite LTCI has been getting more and more attention and promotion, there was a lack of qualitative study to explore the experiences of family caregivers who were directly involved in the care of disabled people enrolled in these projects. This study aimed to explore the experiences of family caregivers in the caregiving process within the context of LTCI.

Methods: This qualitative study used inductive content analysis to explore the experiences of family caregivers of disabled people. Fifteen family caregivers from long-term care service companies and communities in Nantong city were purposively selected to participate in the study between December 2023 to February 2024. Semi-structured in-depth interviews were conducted to collect data. The interviews were audio-recorded and transcribed verbatim.

Results: The results revealed a total of five major themes with thirteen sub-themes including: (1) caregiver fatigue (i.e. heavy daily care tasks, and lack of rest); (2) emotional stress (helplessness and depression, and isolated and alone); (3) perceived benefits of caregiving (emotional connection, and a new outlook on life); (4) more expectations for LTCI (expect respite care, expect medical care facilities, expect longer service duration and frequency, and expect more economic subsidies); and (5) positive evaluations of LTCI (provide psychological support, reduce the burden of care, and professional care services).

Conclusions: This study's findings improved our understanding of caregiving experiences among family caregivers of disabled people enrolled in LTCI. Identifying caregivers' experiences enabled the authorities to develop support strategies and interventions focused on helping them reduce the caregiver burden.

Background: In several countries, the role of the genetic nurse has developed over decades, becoming well-recognized and integrated into healthcare systems. In contrast, in Italy, this role is still emerging, with no formal legal recognition and limited awareness among healthcare professionals and hospital administrators. Given this context, it is crucial to assess how the role and activities of nurses in genetic clinics in Italy are perceived.

Methods: Phenomenological qualitative study was performed. Three focus groups and one individual interview were conducted to collect data between April and November 2022 and transcribed verbatim. Phenomenological analysis was used to provide a comprehensive description of the overall thematic map and to interpret the data.

Results: A purposive sample of 14 Italian nurses with working experience in genetic clinics were recruited for interviews. Three themes were identified: (a) Education, (b) Working in genetic clinics, and (c) Acknowledgement of genetic nurse role. The absence of genetics education in nursing programs has led to on-the-job training in this field. The activities performed were unclear since they were neither standardized nor recognized. The role of the genetic nurse was not acknowledged, and in Italy, nurses trained in genetics did not have the opportunity to choose their recruitment as it was not voluntary.

Conclusions: This evidence highlights the need for formally recognizing the role of the genetic nurse in Italy. This could be achieved through the definition of standard activities and the implementation of formal education in genetics and genomic fields.

Background: Depression seriously damage the health of nurses. It is not conducive to the provision of medical services and hospital management. Meanwhile, nurses are a highly vulnerable group to workplace violence (WPV), increasing the risk of depression. Nurses with different personalities may have various views and feelings towards WPV, and their impact on depression may also vary. This study aims to reveal the impact of the five-pattern personality traits of traditional Chinese medicine (TCM) on WPV and depression among nurses, providing a new perspective for managers to implement psychological interventions.

Methods: A cross-sectional study was conducted. 2,788 valid questionnaires nationwide were collected based on Wenjuanxing from June to July 2024. We used Patient Health Questionnaire Depression Scale-9 item, The five- pattern Personality Traits of TCM Scale, and Workplace Violence Scale. We used latent class analysis, structural equation modeling, and simple slope analysis to analyze depression classes, mediating effects, and moderation effects, respectively.

Results: Depression is classified into three types: "Good mental health group" (34.2%), "Moderate depression group" (23.0%), and "Severe depression group" (42.8%). "Taiyang", "Shaoyang", and "Balance of Yin-Yang" personalities alleviate nurses' feelings of WPV, thereby reducing the impact of WPV on depression. The values of mediating effect are -0.402, -0.393, and -0.426, respectively (P < 0.05). "Taiyin" personality exacerbate nurses' perception of WPV, thereby increasing the impact of WPV on depression. The value of mediating effect is 0.418 (P < 0.05). "Taiyang" and "Shaoyang" personalities reduce the impact of WPV on depression of nurses, and the effect become more significant as the scores increase. The values of moderating effect are 0.033 and -0.0563 respectively (P < 0.05). "Taiyin" and "Shaoyin" personalities increase the impact of WPV on depression, and the effect become more significant as the scores increase. The values of moderating effect are -0.0444 and -0.0220 respectively (P < 0.05).

Conclusions: The prevalence of depression and WPV among Chinese nurses is serious. Excellent personality effectively improve the relationship between WPV and depression. Nursing managers should arrange suitable positions for nurses based on their different personality traits. At the same time, it is necessary to actively cultivate excellent personality traits in nurses to reduce the frequency of WPV and improve their mental health.

Background: Mid- to senior-level nurses play a pivotal role in healthcare. Their reflective ability is crucial for clinical decision-making and the continuous improvement of nursing practices. Although numerous studies have emphasized the importance of enhancing reflective ability among mid- to senior-level nurses, the specific relationship between off-duty professional growth, dual work stress, and reflective ability remains unclear.

Objective: This study aims to investigate the relationship between reflective ability, work stress, and off-duty professional growth among mid- to senior-level nurses in China, and to determine the mediating role of work stress.

Methods: A convenience sampling method was used to recruit 534 mid- to senior-level nurses from three tertiary hospitals in Jiaxing, Zhejiang Province. Data were collected and analyzed using a general information questionnaire, the Leisure Crafting Scale, the Challenge-Hindrance Work Stress Scale, and the Clinical Nurse Reflective Ability Scale.

Results: The mean scores for leisure crafting, challenge stress, hindrance stress, and reflective ability among mid- to senior-level nurses were 23.82 ± 9.17, 16.97 ± 6.49, 16.65 ± 5.44, and 56.26 ± 19.09, respectively. Leisure crafting was positively correlated with reflective ability (r = 0.389, P < 0.001), challenge stress (r = 0.399, P < 0.001), and negatively correlated with hindrance stress (r = -0.367, P < 0.001). Reflective ability was positively correlated with challenge stress (r = 0.350, P < 0.001) and negatively correlated with hindrance stress (r = -0.417, P < 0.001). Both challenge-and hindrance stress partially mediated the relationship between leisure crafting and reflective ability, with mediation effects of 19.7% and 30.8%, respectively.

Conclusion: This study demonstrates that the reflective ability of mid- to senior-level nurses in China is currently at a moderately low level. Enhancing Off-duty professional growth, leveraging the beneficial aspects of challenge stress, and reducing the negative effects of hindrance stress can notably improve reflective ability. These efforts can lay a strong foundation for the continuous enhancement of nursing quality.

Background: Evidence shows harmful effects of e-cigarettes on health. There is limited data on the use of e-cigarettes among nursing students. This study aimed to investigate the usage, knowledge, and attitudes towards e-cigarettes among nursing students in Croatia, as well as their views on the role of nurses in counseling patients and assisting with smoking cessation.

Methods: This cross-sectional study was conducted via an online questionnaire among nursing students at 10 universities in Croatia in March/April 2024. Students were asked questions about socio-demographics, knowledge and attitudes towards e-cigarettes and their views on the role of nurses in counseling patients and assisting with smoking cessation.

Results: The study included 1,039 participants; 89% were women, 43% were smokers; 53% used e-cigarettes and 76% used them for recreational purposes. 21% of participants agreed that e-cigarettes are an effective method for quitting smoking. More than half indicated that e-cigarettes could encourage non-smokers to start smoking. The majority (60%) reported that they had never received education on smoking cessation at university. Furthermore, 66% stated that they did not feel confident advising smokers about e-cigarettes. The majority (70%) considered physicians to be the most knowledgeable health experts to advise and educate users of e-cigarettes. There were no significant differences in attitudes between smokers and non-smokers on the use of e-cigarettes. Participants demonstrated insufficient knowledge about e-cigarettes. Non-smokers had more positive attitudes towards the role of nurses in combating smoking compared to smokers. Participants who had received education on smoking cessation were more willing to advise smokers and had clearer views on the risks and the importance of the nurse's role in the quitting process compared to those who had not received such education. Smoking status and age were significant predictors of counseling confidence.

Conclusion: The study found a high prevalence of smoking and e-cigarette use among Croatian nursing students, along with limited knowledge and generally negative attitudes towards e-cigarettes. It highlighted gaps in education regarding the health risks of e-cigarettes and the lack of practical skills needed to help smokers quit, suggesting that nursing programs should update their curricula to better prepare students in these areas.

Background: Interpersonal sensitivity and self-efficacy are key psychological traits that critically impact the mental well-being and professional growth of nursing students. However, the complex interplay between interpersonal sensitivity and self-efficacy of nursing students has not been fully explored.

Purpose: This study aimed to explore the complex relationship between interpersonal sensitivity and self-efficacy in nursing students using network analysis, identifying key symptoms within this network.

Method: A total of 864 nursing students were recruited in this study. The Chinese Version of the Short Form of the Interpersonal Sensitivity Measure (IPSM-CS) and The New General Self-Efficacy Scale (NGSES) were used to assess interpersonal sensitivity and self-efficacy, respectively. Centrality and bridge centrality indices were used to identify central symptoms and bridge symptoms. Network stability was examined using the case-dropping procedure. The Network Comparison Test was used to investigate the network differences by gender in nursing students.

Results: The strongest direct relation was observed between the symptoms of interpersonal sensitivity "I feel happy when someone compliments me" and "I can make other people feel happy". "I feel happy when someone compliments me" exhibited the highest node strength within the interpersonal sensitivity and self-efficacy network, followed by "If others knew the real me, they would not like me" and "I worry about being criticized for things that I have said or done". "Faced with difficult tasks, confident that it can be accomplished" exhibited the highest bridge strength, followed by "Ability to successfully overcome many challenges". The stability tests of the whole network indicated robustness.

Conclusion: This study highlighted the intricate and dynamic association between interpersonal sensitivity and self-efficacy among nursing students. Identifying central and bridge symptoms can provide nursing educators with valuable insights, benefiting them in enhancing nursing students' mental health by giving positive feedback, fostering self-awareness, and reinforcing coping strategies.

Clinical trial number: Not applicable.

Background: There is a critical shortage of registered nurses working in regional, rural and remote Australia. It is the people from these areas that are most likely to address this shortage. This research therefore sets out to explore the question "what is known about the experiences of regional, rural and remote Australian women undertaking a Bachelor of Nursing program delivered online?".

Methods: The methodology was an integrative literature review which included: 1) problem identification, 2) literature search, 3) data evaluation, 4) data analysis and 5) conclusion. Articles identified as part of the review explored different aspects of the research question.

Results: Using thematic analysis, it was possible to extrapolate four interrelating themes: (1) juggling 'women's work' and study, (2) the online learning environment is isolating, (3) the cost of clinical placement, and (4) maintaining overall wellness while studying.

Conclusion: The literature consistently failed to explore the intersection of the complex challenges facing these students. What is important about this integrative literature review, however, is that the themes identified provide a small and incomplete insight into the experiences of such women, and with a workforce shortage already in play and students continuing to withdraw from their studies, there is a need to find a way to better serve regional, rural and remote Bachelor of Nursing students and their communities.

Background: This study aimed to integrate the experiences of caregivers of children with Down syndrome during the care process and understand their feelings and needs.

Methods: We used Page et al.'s (2021) Preferred Reporting Items for Systematic Reviews and Meta-synthesis Statement. Ten databases (Web of Science, PubMed, EMBASE, Cochrane Library, CINAHL, PsycInfo, China Biology Medicine, China National Knowledge Infrastructure, Wanfang Data, and China Science and Technology Journal Database) were searched for relevant studies published from the inception of the database to October 2023. Eight qualitative studies were analysed. The following seven themes were included: 'feeding pressure', 'hope for education', 'societal rejection and stigma', 'psychological pressure', 'caring burden', 'family burden', and 'family adaptation and self-growth'.

Results: We found that feeding pressures, educational concerns, language difficulties, and discrimination and stigmatisation led to psychological, economic, and family stress in caregivers of children with Down syndrome. We document the need for strong coping mechanisms and support systems for these families from medical and psychological institutions and a need for public education and awareness.

Conclusions: We summarised the daily care experiences of caregivers of children with Down syndrome. Our findings provide a scientific basis for further research focused on reducing physical and mental pressure on caregivers and improving the quality of family life.