To evaluate the mediating role of occupational self-efficacy and the moderating role of perceived social support in the relationship between nurses’ role overload and work engagement.
Background
With the increasing frequency of disasters and multiple emergencies, role overload has emerged as a critical issue in nursing practice. Understanding how to manage nurses' role overload to promote their work engagement is essential for improving healthcare outcomes.
Methods
For this cross-sectional study, conducted from January 2023 to February 2023, 209 nurses were recruited by convenience sampling from six hospitals in China. Data analysis was performed with SPSS 22.0 and Mplus 8.3.
Results
Nurses’ role overload negatively affected work engagement. Occupational self-efficacy partially mediated the relationship between nurses’ role overload and work engagement. Perceived social support negatively moderated the relationship between nurses’ role overload and occupational self-efficacy and the indirect effect between nurses’ role overload and work engagement via occupational self-efficacy.
Conclusion
Nurses’ role overload can reduce work engagement by diminishing occupational self-efficacy, and perceived social support mitigates this negative indirect effect.
Implications for nursing and health policy
In situations characterized by frequent disasters and multiple emergencies, interventions to improve work engagement should focus on diminishing role overload among nurses and improving their occupational self-efficacy. Additionally, policymakers and nursing managers should prioritize the mental health and emotional needs of nurses to increase their perceived social support.
{"title":"How Role Overload Impacts Nurses’ Work Engagement in Healthcare Emergencies: A Moderated Mediation Model","authors":"Yuanli Guo, Po-Chien Chang, Shuyue Liu, Qihai Cai","doi":"10.1111/inr.70125","DOIUrl":"10.1111/inr.70125","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Aim</h3>\u0000 \u0000 <p>To evaluate the mediating role of occupational self-efficacy and the moderating role of perceived social support in the relationship between nurses’ role overload and work engagement.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>With the increasing frequency of disasters and multiple emergencies, role overload has emerged as a critical issue in nursing practice. Understanding how to manage nurses' role overload to promote their work engagement is essential for improving healthcare outcomes.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>For this cross-sectional study, conducted from January 2023 to February 2023, 209 nurses were recruited by convenience sampling from six hospitals in China. Data analysis was performed with SPSS 22.0 and Mplus 8.3.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Nurses’ role overload negatively affected work engagement. Occupational self-efficacy partially mediated the relationship between nurses’ role overload and work engagement. Perceived social support negatively moderated the relationship between nurses’ role overload and occupational self-efficacy and the indirect effect between nurses’ role overload and work engagement via occupational self-efficacy.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>Nurses’ role overload can reduce work engagement by diminishing occupational self-efficacy, and perceived social support mitigates this negative indirect effect.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Implications for nursing and health policy</h3>\u0000 \u0000 <p>In situations characterized by frequent disasters and multiple emergencies, interventions to improve work engagement should focus on diminishing role overload among nurses and improving their occupational self-efficacy. Additionally, policymakers and nursing managers should prioritize the mental health and emotional needs of nurses to increase their perceived social support.</p>\u0000 </section>\u0000 </div>","PeriodicalId":54931,"journal":{"name":"International Nursing Review","volume":"72 4","pages":""},"PeriodicalIF":3.7,"publicationDate":"2025-10-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145403163","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"The Crucial Role of Nursing Tutoring in Developing Nursing Students’ Cultural Skills","authors":"Gian Domenico Giusti, Rocco Mazzotta","doi":"10.1111/inr.70122","DOIUrl":"10.1111/inr.70122","url":null,"abstract":"","PeriodicalId":54931,"journal":{"name":"International Nursing Review","volume":"72 4","pages":""},"PeriodicalIF":3.7,"publicationDate":"2025-10-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145403141","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
<div> <section> <h3> Aim</h3> <p>To systematically review the research on the application of discrete choice experiments (DCEs) in nurses’ job preferences.</p> </section> <section> <h3> Background</h3> <p>As essential frontline healthcare professionals, nurses experience disproportionately high turnover rates globally. This persistent challenge undermines workforce stability, compromises patient care quality, and increases organisational costs. Understanding the underlying factors that influence nurses’ job preferences is therefore critical to developing effective recruitment and retention strategies. Discrete choice experiments (DCEs) provide a robust methodological framework for quantifying these preferences and revealing how nurses value different job attributes.</p> </section> <section> <h3> Methods</h3> <p>Ten electronic databases were systematically searched from inception until March 1, 2025. Two researchers independently used the purpose, respondents, explanation, findings, and significance (PREFS) checklist to evaluate the quality of the included studies. Thematic analysis was used to classify the attributes of nurses’ job preferences into broad categories and subcategories; the frequency, significance, relative importance, and willingness-to-pay of each attribute in the included studies were analyzed.</p> </section> <section> <h3> Results</h3> <p>Twenty-one articles spanning nine countries were included, with a total of 140 individual attributes extracted and divided thematically into three broad categories and eight subcategories. Existence needs, including income, working environment, job stability, and workload, were the most frequently reported broad category.</p> </section> <section> <h3> Discussion</h3> <p>This review underscores the decisive influence of nonfinancial attributes on nurses’ employment decisions and delineates the nuanced hierarchy of these preferences across multiple dimensions. It is crucial to combine economic and noneconomic factors in formulating targeted incentive policies.</p> </section> <section> <h3> Conclusion</h3> <p>Nurses weighed both financial and nonfinancial factors when making job choices. Additionally, there were differences in the needs of nurses with different job characteristics, e.g., senior nurses were concerned with work autonomy, while junior nurses were more interested in the working atmosphere.</p> </section> <section> <h3> Implications for nursing</h3>
{"title":"Nurses’ Job Preferences: A Systematic Review of Discrete Choice Experiments","authors":"Ting Cao, Huan Chen, Shi Chen, Xinyu Chen, Xianying Lu, Dingxi Bai, Yuhang Li, Zihao Song, Chaoming Hou, Jing Gao","doi":"10.1111/inr.70117","DOIUrl":"10.1111/inr.70117","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Aim</h3>\u0000 \u0000 <p>To systematically review the research on the application of discrete choice experiments (DCEs) in nurses’ job preferences.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>As essential frontline healthcare professionals, nurses experience disproportionately high turnover rates globally. This persistent challenge undermines workforce stability, compromises patient care quality, and increases organisational costs. Understanding the underlying factors that influence nurses’ job preferences is therefore critical to developing effective recruitment and retention strategies. Discrete choice experiments (DCEs) provide a robust methodological framework for quantifying these preferences and revealing how nurses value different job attributes.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Ten electronic databases were systematically searched from inception until March 1, 2025. Two researchers independently used the purpose, respondents, explanation, findings, and significance (PREFS) checklist to evaluate the quality of the included studies. Thematic analysis was used to classify the attributes of nurses’ job preferences into broad categories and subcategories; the frequency, significance, relative importance, and willingness-to-pay of each attribute in the included studies were analyzed.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Twenty-one articles spanning nine countries were included, with a total of 140 individual attributes extracted and divided thematically into three broad categories and eight subcategories. Existence needs, including income, working environment, job stability, and workload, were the most frequently reported broad category.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Discussion</h3>\u0000 \u0000 <p>This review underscores the decisive influence of nonfinancial attributes on nurses’ employment decisions and delineates the nuanced hierarchy of these preferences across multiple dimensions. It is crucial to combine economic and noneconomic factors in formulating targeted incentive policies.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>Nurses weighed both financial and nonfinancial factors when making job choices. Additionally, there were differences in the needs of nurses with different job characteristics, e.g., senior nurses were concerned with work autonomy, while junior nurses were more interested in the working atmosphere.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Implications for nursing</h3>\u0000 ","PeriodicalId":54931,"journal":{"name":"International Nursing Review","volume":"72 4","pages":""},"PeriodicalIF":3.7,"publicationDate":"2025-10-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145356888","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Tong Liu, Jie Mi, Liping Liu, Jun Wang, Yingzhuo Ma, Qinghua Zhao, Mingzhao Xiao
{"title":"The Pivotal Role of the International Council of Nurses in Advancing Global Patient Safety","authors":"Tong Liu, Jie Mi, Liping Liu, Jun Wang, Yingzhuo Ma, Qinghua Zhao, Mingzhao Xiao","doi":"10.1111/inr.70115","DOIUrl":"10.1111/inr.70115","url":null,"abstract":"","PeriodicalId":54931,"journal":{"name":"International Nursing Review","volume":"72 4","pages":""},"PeriodicalIF":3.7,"publicationDate":"2025-10-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145350209","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
<div> <section> <h3> Aim</h3> <p>To explore nurse managers’ awareness and concerns about climate change, the factors influencing their perceptions, and their leadership roles in sustainable healthcare.</p> </section> <section> <h3> Background</h3> <p>Nurse managers play a pivotal role in promoting climate resilience and embedding sustainability into healthcare organizations. Their leadership is essential for mobilizing teams and aligning healthcare systems with sustainability goals, yet evidence on their awareness, concerns, and leadership in this area remains limited.</p> </section> <section> <h3> Methods</h3> <p>A mixed-methods convergent parallel design was employed. Quantitative data were collected through surveys of nurse managers, and qualitative data were obtained from focus group discussions. Findings were analyzed using descriptive and interpretive approaches and integrated through the Climate Adaptation Framework.</p> </section> <section> <h3> Results</h3> <p>Nurse managers reported high awareness and concern regarding climate change. Awareness was shaped by a younger age, higher education, and prior climate training. Despite strong motivation, participants highlighted limited institutional understanding, weak policy frameworks, and resource constraints. Qualitative insights revealed fragmented planning and a pressing need for interprofessional collaboration.</p> </section> <section> <h3> Discussion</h3> <p>Advancing climate action requires shifting from individual efforts to system-level strategies. Nurse managers are positioned to inspire teams and foster innovation, but their effectiveness depends on stronger organizational commitment, adequate resources, and aligned policies.</p> </section> <section> <h3> Conclusion</h3> <p>Although nurse managers show readiness to lead, structural barriers such as inadequate policies, funding, and training restrict sustainable action and underutilize their leadership potential.</p> </section> <section> <h3> Implications for Nursing</h3> <p>Embedding climate education into curricula, strengthening institutional sustainability initiatives, and fostering cross-sector collaborations are essential for leadership development.</p> </section> <section> <h3> Implications for Nursing Policy</h3> <p>Policies should prioritize sustainability leadership training, allocate resou
{"title":"Nurse Managers' Awareness and Concerns About Climate Change and Leadership in Sustainable Healthcare Practices: A Mixed-Methods Study","authors":"Seda Sarıköse, Tuba Sengul, Seda Güney","doi":"10.1111/inr.70120","DOIUrl":"10.1111/inr.70120","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Aim</h3>\u0000 \u0000 <p>To explore nurse managers’ awareness and concerns about climate change, the factors influencing their perceptions, and their leadership roles in sustainable healthcare.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Nurse managers play a pivotal role in promoting climate resilience and embedding sustainability into healthcare organizations. Their leadership is essential for mobilizing teams and aligning healthcare systems with sustainability goals, yet evidence on their awareness, concerns, and leadership in this area remains limited.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>A mixed-methods convergent parallel design was employed. Quantitative data were collected through surveys of nurse managers, and qualitative data were obtained from focus group discussions. Findings were analyzed using descriptive and interpretive approaches and integrated through the Climate Adaptation Framework.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Nurse managers reported high awareness and concern regarding climate change. Awareness was shaped by a younger age, higher education, and prior climate training. Despite strong motivation, participants highlighted limited institutional understanding, weak policy frameworks, and resource constraints. Qualitative insights revealed fragmented planning and a pressing need for interprofessional collaboration.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Discussion</h3>\u0000 \u0000 <p>Advancing climate action requires shifting from individual efforts to system-level strategies. Nurse managers are positioned to inspire teams and foster innovation, but their effectiveness depends on stronger organizational commitment, adequate resources, and aligned policies.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>Although nurse managers show readiness to lead, structural barriers such as inadequate policies, funding, and training restrict sustainable action and underutilize their leadership potential.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Implications for Nursing</h3>\u0000 \u0000 <p>Embedding climate education into curricula, strengthening institutional sustainability initiatives, and fostering cross-sector collaborations are essential for leadership development.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Implications for Nursing Policy</h3>\u0000 \u0000 <p>Policies should prioritize sustainability leadership training, allocate resou","PeriodicalId":54931,"journal":{"name":"International Nursing Review","volume":"72 4","pages":""},"PeriodicalIF":3.7,"publicationDate":"2025-10-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145350181","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Elizabeth A. Rosser, Kylie Russell, Yeow Chye Ng, Tanya F. Lott, Ellen Buckner
Aim
To report the progress made from evaluating the fourth cohort of a year-long global leadership mentoring programme, pairing early career nurse leaders with more established leaders across different global regions. Additionally, groups of five pairs, facilitated by an experienced coordinator, were used.
Introduction
Recent evidence reinforces the value of formal structured mentorship programmes to support nurse leadership development, organisational efficiency and patient outcomes.
Methods
A survey approach using both pre- and post-survey questionnaires was refined from previous cohorts and reported using the STROBE checklist. Using closed questions supported by three open-ended questions, participants focused on their expectations, cultural understanding and leadership. Data were collected between 2021 and 2023, from a total of 26 pairs and analysed utilising descriptive statistics and thematic analysis using the mixed-methods appraisal tool.
Findings
Data were merged to form the three themes of commitment, confidence and cultural competence and their impact on global leadership. The majority of dyads gained considerably from the programme, both within their pairs but also in the small coordinator groups, gaining a broader perspective and wider network of global leaders to connect with long after completion of the programme.
Conclusion
The use of small coordinator groups enhances the already successful individual global mentoring. More work to develop policy discussions and accessible connections in these small groups potentially enhances cultural competence and leadership skills.
Implications for Nursing and Nursing Policy
Individual mentoring supported by small facilitator groups could be considered as a policy imperative by the International Council of Nurses and National Nursing Councils to encourage wider networking opportunities and learning across different cultures in a secure environment to prepare for leadership on a global stage and enhance care standards.
{"title":"Sustaining Success: The Evolving Impact of a Global Leadership Mentoring Programme","authors":"Elizabeth A. Rosser, Kylie Russell, Yeow Chye Ng, Tanya F. Lott, Ellen Buckner","doi":"10.1111/inr.70121","DOIUrl":"10.1111/inr.70121","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Aim</h3>\u0000 \u0000 <p>To report the progress made from evaluating the fourth cohort of a year-long global leadership mentoring programme, pairing early career nurse leaders with more established leaders across different global regions. Additionally, groups of five pairs, facilitated by an experienced coordinator, were used.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Introduction</h3>\u0000 \u0000 <p>Recent evidence reinforces the value of formal structured mentorship programmes to support nurse leadership development, organisational efficiency and patient outcomes.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>A survey approach using both pre- and post-survey questionnaires was refined from previous cohorts and reported using the STROBE checklist. Using closed questions supported by three open-ended questions, participants focused on their expectations, cultural understanding and leadership. Data were collected between 2021 and 2023, from a total of 26 pairs and analysed utilising descriptive statistics and thematic analysis using the mixed-methods appraisal tool.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Findings</h3>\u0000 \u0000 <p>Data were merged to form the three themes of commitment, confidence and cultural competence and their impact on global leadership. The majority of dyads gained considerably from the programme, both within their pairs but also in the small coordinator groups, gaining a broader perspective and wider network of global leaders to connect with long after completion of the programme.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>The use of small coordinator groups enhances the already successful individual global mentoring. More work to develop policy discussions and accessible connections in these small groups potentially enhances cultural competence and leadership skills.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Implications for Nursing and Nursing Policy</h3>\u0000 \u0000 <p>Individual mentoring supported by small facilitator groups could be considered as a policy imperative by the International Council of Nurses and National Nursing Councils to encourage wider networking opportunities and learning across different cultures in a secure environment to prepare for leadership on a global stage and enhance care standards.</p>\u0000 </section>\u0000 </div>","PeriodicalId":54931,"journal":{"name":"International Nursing Review","volume":"72 4","pages":""},"PeriodicalIF":3.7,"publicationDate":"2025-10-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145338227","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Isadora Andriola, Marjorie Melo, Andrea Sonenberg, Victor Petreca, Mario Lins Galvão de Oliveira, Ana Luisa Brandão de Carvalho Lira, Brittney Van de Water
Aim
To understand the factors influencing investment in nursing from the perspective of relevant interest holders in nursing.
Introduction
Brazil's healthcare system faces significant inequities in healthcare access, leading to health disparities. There is a strong link between healthcare access and health outcomes, highlighting the importance of nursing roles and regulatory policies.
Methods
A qualitative descriptive analysis was conducted using purposive and snowball sampling to recruit and interview 15 participants from various nursing, education, and leadership roles in Brazil. Data were thematically analyzed in Dedoose, ensuring rigor via triangulation, reflexivity, and an audit trail.
Results
Three major themes emerged. First, prioritizing health facilitates investment in nursing. Second, intrinsic challenges include barriers within the profession, such as educational issues and fragmented professional structures. Third, extrinsic barriers, including health system fractures and institutional issues, hinder investment in nursing.
Discussion
Effective policy reform requires overcoming barriers in nursing education, leadership, employment, and service delivery. In Brazil, priority areas include clarifying scopes of practice, updating regulatory frameworks, and expanding regional access to nursing education.
Conclusion
Investing in nursing across education, employment, leadership, and service delivery is worthwhile for a country's health and economy. Educational opportunities translate to job opportunities only if governments invest in all levels of nursing and if a country can absorb well-trained and qualified nurses into the healthcare system.
Implications for nursing and nursing policy
This study revealed obstacles and enabling factors related to an investment in nursing by Brazil, offering insights applicable to countries with similar health systems. Recommendations include removing intrinsic restraints, endeavoring to empower nurses, and eliminating extrinsic barriers, all of which could support investment in nursing, ultimately an investment in population health.
{"title":"Facilitators and Barriers to Investment in the Brazilian Nursing Workforce: A Qualitative Study","authors":"Isadora Andriola, Marjorie Melo, Andrea Sonenberg, Victor Petreca, Mario Lins Galvão de Oliveira, Ana Luisa Brandão de Carvalho Lira, Brittney Van de Water","doi":"10.1111/inr.70113","DOIUrl":"10.1111/inr.70113","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Aim</h3>\u0000 \u0000 <p>To understand the factors influencing investment in nursing from the perspective of relevant interest holders in nursing.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Introduction</h3>\u0000 \u0000 <p>Brazil's healthcare system faces significant inequities in healthcare access, leading to health disparities. There is a strong link between healthcare access and health outcomes, highlighting the importance of nursing roles and regulatory policies.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>A qualitative descriptive analysis was conducted using purposive and snowball sampling to recruit and interview 15 participants from various nursing, education, and leadership roles in Brazil. Data were thematically analyzed in Dedoose, ensuring rigor via triangulation, reflexivity, and an audit trail.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Three major themes emerged. First, prioritizing health facilitates investment in nursing. Second, intrinsic challenges include barriers within the profession, such as educational issues and fragmented professional structures. Third, extrinsic barriers, including health system fractures and institutional issues, hinder investment in nursing.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Discussion</h3>\u0000 \u0000 <p>Effective policy reform requires overcoming barriers in nursing education, leadership, employment, and service delivery. In Brazil, priority areas include clarifying scopes of practice, updating regulatory frameworks, and expanding regional access to nursing education.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>Investing in nursing across education, employment, leadership, and service delivery is worthwhile for a country's health and economy. Educational opportunities translate to job opportunities only if governments invest in all levels of nursing and if a country can absorb well-trained and qualified nurses into the healthcare system.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Implications for nursing and nursing policy</h3>\u0000 \u0000 <p>This study revealed obstacles and enabling factors related to an investment in nursing by Brazil, offering insights applicable to countries with similar health systems. Recommendations include removing intrinsic restraints, endeavoring to empower nurses, and eliminating extrinsic barriers, all of which could support investment in nursing, ultimately an investment in population health.</p>\u0000 </section>\u0000 </div>","PeriodicalId":54931,"journal":{"name":"International Nursing Review","volume":"72 4","pages":""},"PeriodicalIF":3.7,"publicationDate":"2025-10-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145314281","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Hong Jiang, Hangcheng Liu, Hongjin Wu, Yuwei Yang, Xixi Li
<div> <section> <h3> Aim</h3> <p>To compare the predictive performance of the Morse Fall Scale and the Clinical Judgment Method for Fall Risk for assessing fall risk among hospitalized adults using real-world data.</p> </section> <section> <h3> Introduction</h3> <p>Inpatient falls pose significant threats to patient safety and healthcare costs. While standardized tools like the Morse Fall Scale and the Clinical Judgment Method for Fall Risk are widely used, their comparative effectiveness in diverse clinical contexts requires further investigation.</p> </section> <section> <h3> Methods</h3> <p>This retrospective study analyzed inpatient data from a tertiary hospital between January 1, 2022, and December 31, 2023. Adult inpatients (≥18 years) with hospital stays ≥24 hours and available fall risk assessment records within 24 hours of admission were included. Patients with incomplete demographic or assessment data were excluded. Covariance analysis, receiver operating characteristic (ROC) curves, sensitivity, and other metrics were used to compare the predictive efficacy of both tools across different departments, genders, and age groups.</p> </section> <section> <h3> Results</h3> <p>A total of 206,846 inpatients were included, with male 48.3%(<i>n</i> = 99,885)andfemale 51.7% (<i>n</i> = 106,961) patients. Most were admitted to non-surgical departments (56.0%); 36.97% were evaluated using Clinical Judgment Method for Fall Risk, and 73.03% using the Morse Fall Scale. The overall fall incidence was 0.1%. For predicting inpatient falls, Clinical Judgment Method for Fall Risk demonstrated an area under the curve (AUC) of 0.602, while the Morse Fall Scale showed an AUC of 0.825. The Clinical Judgment Method for Fall Risk exhibited 100% sensitivity. Age significantly influenced fall risk and the assessment results of both tools, whereas gender showed no statistical significance across all indicators. Departmental differences were observed in fall events and Morse Fall Scale scores but did not affect Clinical Judgment Method for Fall Risk. The stratified analysis revealed that the Morse Fall Scale performed exceptionally well in surgical departments (AUC = 0.887) and among patients aged ≥75 years (AUC = 0.837).</p> </section> <section> <h3> Discussion</h3> <p>The tools exhibit complementary strengths: the Morse Fall Scale provides detailed risk stratification capability, while the Clinical Judgment Method for Fall Risk offers efficiency for rapid screening. A two-stage model combining both approaches shows potential for enhancing risk assessment but requires f
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<p>Nurses are an integral element of the global response to healthcare emergencies, whether they are caused by natural disasters, terrorism, armed conflicts or humanitarian crises. In all of these circumstances, the fragility of many countries healthcare system is laid bare and staff are left to cope as front-line providers (Al Thobaity <span>2024</span>). Nurses are major contributors at times of war and disaster as they work not only in the immediate emergency response, but they cope with the psychological and long-term aspects of recovery. When <i>International Nursing Review</i> put out the call for papers for this virtual special issue in 2024, the world had faced unprecedented global disaster challenges. Hurricane Helene and Typhoon Yagi had caused widespread damage, and flooding had also claimed a number of lives in Africa, Spain, Brazil, Bangladesh and India. Other countries were impacted by extreme heat with thousands of people dying in Saudi Arabia, North America and Pakistan. Overall, natural disasters killed more than 16,753 people in 2024, with extreme weather events accounting for the majority of these fatalities (Centre for Research on the Epidemiology of Disasters <span>2024</span>). This figure is staggering as disasters had only claimed 65,566 lives in the previous 20-year period (Centre for Research on the Epidemiology of Disasters <span>2024</span>). It was clear to me and my fellow editors that we needed to think differently about the role of nurses in disasters as many countries were now experiencing significant mass casualty events when disaster competencies were not really embedded in nursing education.</p><p>During disasters, nurses act as first responders, managing triage, stabilizing patients and delivering emergency care. At the same time, colleagues from other non-emergency care areas, such as public health, are ensuring that displaced people with no access to medication are appropriately managed. Wherever care is provided, nurses need ingenuity and resourcefulness in emergency situations in order to deliver care in unusual environments with resource limitations (Veenema <span>2009</span>).</p><p>Nurses have a significant role beyond physical health and immediate emergency care. They address the longer-term impact of disasters on individuals and communities. In the aftermath, nurses deliver psychological first aid and trauma-informed interventions to people impacted by disasters and conflict. The mental health toll of such events on the population is profound, as is the impact on nurses and other healthcare workers. The COVID-19 pandemic has brought into the spotlight the impact of moral insult and injury that having to work in extreme circumstances and having to make challenging ethical decisions has on individuals (Scott et al. <span>2023</span>). Working during disasters and conflict also brings such challenges and we need to ensure the workforce is both resilient and supported to deliver such care (Xue et al. <spa
无论是由自然灾害、恐怖主义、武装冲突还是人道主义危机引起的突发卫生事件，护士都是全球应对突发卫生事件不可或缺的组成部分。在所有这些情况下，许多国家卫生保健系统的脆弱性暴露无遗，工作人员只能作为一线提供者应对（Al Thobaity 2024）。在战争和灾难时期，护士是主要的贡献者，因为她们不仅在立即的紧急反应中工作，而且还处理心理和长期恢复方面的问题。当《国际护理评论》在2024年为这期虚拟特刊征集论文时，世界面临着前所未有的全球灾难挑战。飓风“海伦”和台风“八木”造成了广泛的破坏，洪水在非洲、西班牙、巴西、孟加拉国和印度也夺去了许多人的生命。其他国家也受到了极端高温的影响，沙特阿拉伯、北美和巴基斯坦有数千人死亡。总体而言，2024年自然灾害造成的死亡人数超过16753人，其中极端天气事件占大多数（2024年灾害流行病学研究中心）。这一数字令人震惊，因为在过去的20年里，灾害仅夺去了65,566人的生命（2024年灾害流行病学研究中心）。我和我的编辑同事们很清楚，我们需要以不同的方式思考护士在灾难中的角色，因为许多国家正在经历重大的大规模伤亡事件，而灾难能力并没有真正融入护理教育。在灾难期间，护士作为第一响应者，管理分类，稳定病人并提供紧急护理。与此同时，来自公共卫生等其他非紧急护理领域的同事正在确保对无法获得药物的流离失所者进行适当管理。无论在哪里提供护理，护士在紧急情况下都需要聪明才智和足智多谋，以便在资源有限的不寻常环境中提供护理（Veenema 2009）。除了身体健康和紧急护理之外，护士还有重要的作用。它们处理灾害对个人和社区的长期影响。灾后，护士向受灾害和冲突影响的人们提供心理急救和创伤知情干预。这类事件对人口的精神健康造成的影响是深远的，对护士和其他卫生保健工作者的影响也是如此。2019冠状病毒病大流行凸显了必须在极端环境下工作、必须做出具有挑战性的道德决定对个人造成的道德侮辱和伤害的影响（Scott et al. 2023）。在灾害和冲突期间工作也会带来这样的挑战，我们需要确保劳动力既有弹性，也有支持，以提供此类护理（Xue et al. 2020）。在灾难发生后的一段时间里，当人们试图恢复正常的时候，护理的作用也延伸到发展社区的恢复能力。这一角色需要一套不同的技能和知识，因为它涉及更广泛的公共卫生干预措施，包括监测疾病和与社区合作重建社会结构和加强社区网络（灾后恢复委员会，公共卫生研究所，2015年）。显然，无论是自然灾害还是人为灾害，以及诸如新出现的传染病、生物恐怖主义和大规模伤亡事件等其他挑战，对世界上许多国家来说都是一个始终存在的威胁。正如前面所强调的，气候变化也导致了更多的极端天气事件，这使得自然灾害更加频繁和强烈（Vernick 2025）。现在，“一生一次”的事件每十年发生两到三次是很常见的。极端天气事件、过热和干旱现在影响着许多大陆。由于全球气温上升，风暴、暴雨和飓风等天气事件现在比以前更加强烈（地球正义2024）。2025年6月，在赫尔辛基举行的国际护士理事会（ICN）大会上，ICN首席执行官霍华德·卡顿（Howard Catton）呼吁所有国家的护士关注气候变化和冲突等全球危机，无论他们离自己的国家有多远。这再次表明，各国需要从不同的角度考虑护士和其他卫生专业人员的灾害能力。虽然这些能力多年来一直植根于面临地质和其他威胁的国家，但地球上每个国家现在都面临着极端天气造成的灾难威胁。所有灾难都会给公众和医护人员带来道德挑战和心理创伤，而冲突和战争则会带来长期的挑战或无法忍受的状况。在冲突期间，护士承担着护理、个人风险和关心自己家庭的三重负担。 尽管如此，平民护士仍然不加歧视地提供护理，与受伤的平民一起治疗双方的伤员。在冲突期间，我们越来越多地看到违反国际人道主义法的对卫生设施和卫生工作者的袭击。《日内瓦公约》及其相关议定书规定了这种保护，而如果医院被敌人用于军事行动，则可能失去这种保护。尽管有这种立场，红十字国际委员会明确表示，医院可能失去保护这一事实并不是攻击医院的自由许可证（红十字国际委员会，2023年）。设施如何以及为什么会失去保护，缺乏明确性是一个问题。越来越多的卫生设施被用作盾牌，使卫生保健工作者和患者面临更大的攻击风险。我的观点是，医院‘实施对敌人有害的行为’的概念需要紧急澄清，因为实施这种行为的不是医院设施或工作人员，而是占领这些设施的军队或恐怖主义部队。一想到病人和工作人员不是自己的过错而被困在交火中，对医疗设施的袭击就更加令人憎恶。ICN多次呼吁保护护士、卫生保健工作者和设施，最近全国护理协会代表理事会在2025年6月的会议上提出了一项动议，进一步加强了这一呼吁。尽管如此，在许多冲突地区，攻击仍在继续，并以军事行动发生在这些设施的概念作为借口。联合国概述了冲突如何变得更加根深蒂固，尽管自1946年以来，战争和冲突造成的绝对死亡人数逐年下降。然而，国家内部团体之间的冲突更多了，欧洲和中东地区也发生了引人注目的战争。全球冲突现在处于自第二次世界大战以来的最高水平（Bowman 2025）。在受冲突影响地区工作或在专制政权下提供护理的护士比以往任何时候都多。当然，我们不应该忘记在前线工作的军人同事，他们照顾受伤的士兵。这些人中有许多人还在民用医疗服务机构工作，对战争和冲突带来的挑战，他们并不比他们的同事更加免疫。认识到灾害、战争和冲突变得越来越普遍，需要做些什么来确保卫生保健服务具有复原力，并确保护士做好充分准备？国际护士理事会于2019年发布了第二版灾难护理核心能力（ICN 2019）。核心能力涵盖八个范畴，包括准备及计划、通讯、事故管理、安全及保安、评估、干预、复原及法律及道德。该框架考虑了三个级别的护士，从1级（所有注册护士）到2级（在自己的组织中指定监督和领导应对措施的护士），最后是3级（可部署团队中的一员）护士。核心能力是制定教育计划的有用框架，许多国家已将1级能力纳入注册前护理计划（Ranse et al. 2022； Erkin和Kiyan 2025）。联合国在2022年警告说，世界上有一半的国家没有做好应对灾害的准备（联合国减少灾害风险办公室2022年）。亚太地区和非洲的许多这些国家容易遭受极端天气事件和其他形式的自然灾害，这些灾害往往导致干旱、作物歉收和饥荒。其他国家正在经历越来越多的野火和极端高温事件，并报告感觉准备不足，包括葡萄牙、希腊、西班牙和意大利（Yanatma 2025）。显然，随着灾害风险的增加和冲突的加剧，我们需要确保所有国家都将灾害护理能力纳入初级护士教育，并使医院和公共卫生部门的从业人员做好应对紧急情况的准备。没有这样的准备，各国将无法应对极端天气、自然灾害或冲突引起的紧急情况。本期特刊汇集了大量有关备灾的已发表论文，探讨了应对自然灾害和气候相关灾害的系统准备。在战争和冲突期间，人口的大规模迁移是一个共同特征，无论是在一个国家内部还是到其他国家，两篇论文探讨了来自乌克兰和叙利亚的流离失所人口。特刊还包括广泛的战争和冲突经历，包括一篇启发性的论文《隐藏的声音》，探讨了军事政变期间缅甸护士的工作。
{"title":"The Indispensable Role of Nurses in Disasters, War and Conflict: Clinical Excellence in the Most Challenging Environments","authors":"John Unsworth","doi":"10.1111/inr.70114","DOIUrl":"https://doi.org/10.1111/inr.70114","url":null,"abstract":"<p>Nurses are an integral element of the global response to healthcare emergencies, whether they are caused by natural disasters, terrorism, armed conflicts or humanitarian crises. In all of these circumstances, the fragility of many countries healthcare system is laid bare and staff are left to cope as front-line providers (Al Thobaity <span>2024</span>). Nurses are major contributors at times of war and disaster as they work not only in the immediate emergency response, but they cope with the psychological and long-term aspects of recovery. When <i>International Nursing Review</i> put out the call for papers for this virtual special issue in 2024, the world had faced unprecedented global disaster challenges. Hurricane Helene and Typhoon Yagi had caused widespread damage, and flooding had also claimed a number of lives in Africa, Spain, Brazil, Bangladesh and India. Other countries were impacted by extreme heat with thousands of people dying in Saudi Arabia, North America and Pakistan. Overall, natural disasters killed more than 16,753 people in 2024, with extreme weather events accounting for the majority of these fatalities (Centre for Research on the Epidemiology of Disasters <span>2024</span>). This figure is staggering as disasters had only claimed 65,566 lives in the previous 20-year period (Centre for Research on the Epidemiology of Disasters <span>2024</span>). It was clear to me and my fellow editors that we needed to think differently about the role of nurses in disasters as many countries were now experiencing significant mass casualty events when disaster competencies were not really embedded in nursing education.</p><p>During disasters, nurses act as first responders, managing triage, stabilizing patients and delivering emergency care. At the same time, colleagues from other non-emergency care areas, such as public health, are ensuring that displaced people with no access to medication are appropriately managed. Wherever care is provided, nurses need ingenuity and resourcefulness in emergency situations in order to deliver care in unusual environments with resource limitations (Veenema <span>2009</span>).</p><p>Nurses have a significant role beyond physical health and immediate emergency care. They address the longer-term impact of disasters on individuals and communities. In the aftermath, nurses deliver psychological first aid and trauma-informed interventions to people impacted by disasters and conflict. The mental health toll of such events on the population is profound, as is the impact on nurses and other healthcare workers. The COVID-19 pandemic has brought into the spotlight the impact of moral insult and injury that having to work in extreme circumstances and having to make challenging ethical decisions has on individuals (Scott et al. <span>2023</span>). Working during disasters and conflict also brings such challenges and we need to ensure the workforce is both resilient and supported to deliver such care (Xue et al. <spa","PeriodicalId":54931,"journal":{"name":"International Nursing Review","volume":"72 4","pages":""},"PeriodicalIF":3.7,"publicationDate":"2025-10-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/inr.70114","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145272542","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Ahmad Ayed, Malakeh Z. Malak, Moath Abu Ejheisheh, Ahmad Batran, Mosaab Farajallah, Pearl Handal
Aim
This study examined the relationship between emotional intelligence and caring behaviors among Palestinian Neonatal Intensive Care Unit (NICU) nurses in governmental hospitals across the West Bank.
Background
The NICU is a high-stress environment that presents significant challenges for nurses. Emotional intelligence has a significant role in helping nurses manage environmental stressors and influences the quality of their caring behaviors.
Methods
A cross-sectional design was employed in line with the STROBE guidelines, using a convenience sample of 208 nurses working in level II and III NICUs. Data were collected between January 5 and March 10, 2025, using paper-based surveys that included the Schutte Self-Report Emotional Intelligence Test (SSEIT) and the Caring Behaviors Assessment Tool Nursing Version–Short Form (CBAN-SF).
Results
Participants had a relatively high emotional intelligence level, with a mean score of 117.5 (SD ± 11.4). Similarly, the mean caring behaviors score was 98.8 (SD ± 10.1), suggesting strong satisfaction with caring behaviors. A strong positive correlation was found between emotional intelligence and caring behaviors. Age, work experience, and educational level were also associated with caring behaviors. Emotional intelligence and educational level were significant predictors.
Conclusion
NICU nurses are adequately equipped to deliver empathetic, high-quality care in challenging clinical environments.
Implications for Nursing and/or Health Policy
These findings underscore the need for policymakers and hospital administrators to prioritize continuous professional development and the regular assessment of emotional intelligence
{"title":"The Relationship Between Emotional Intelligence and Caring Behaviors Among Palestinian Nurses in Neonatal Intensive Care Units: A Cross-Sectional Study","authors":"Ahmad Ayed, Malakeh Z. Malak, Moath Abu Ejheisheh, Ahmad Batran, Mosaab Farajallah, Pearl Handal","doi":"10.1111/inr.70116","DOIUrl":"https://doi.org/10.1111/inr.70116","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Aim</h3>\u0000 \u0000 <p>This study examined the relationship between emotional intelligence and caring behaviors among Palestinian Neonatal Intensive Care Unit (NICU) nurses in governmental hospitals across the West Bank.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>The NICU is a high-stress environment that presents significant challenges for nurses. Emotional intelligence has a significant role in helping nurses manage environmental stressors and influences the quality of their caring behaviors.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>A cross-sectional design was employed in line with the STROBE guidelines, using a convenience sample of 208 nurses working in level II and III NICUs. Data were collected between January 5 and March 10, 2025, using paper-based surveys that included the Schutte Self-Report Emotional Intelligence Test (SSEIT) and the Caring Behaviors Assessment Tool Nursing Version–Short Form (CBAN-SF).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Participants had a relatively high emotional intelligence level, with a mean score of 117.5 (SD ± 11.4). Similarly, the mean caring behaviors score was 98.8 (SD ± 10.1), suggesting strong satisfaction with caring behaviors. A strong positive correlation was found between emotional intelligence and caring behaviors. Age, work experience, and educational level were also associated with caring behaviors. Emotional intelligence and educational level were significant predictors.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>NICU nurses are adequately equipped to deliver empathetic, high-quality care in challenging clinical environments.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Implications for Nursing and/or Health Policy</h3>\u0000 \u0000 <p>These findings underscore the need for policymakers and hospital administrators to prioritize continuous professional development and the regular assessment of emotional intelligence</p>\u0000 </section>\u0000 </div>","PeriodicalId":54931,"journal":{"name":"International Nursing Review","volume":"72 4","pages":""},"PeriodicalIF":3.7,"publicationDate":"2025-10-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145272319","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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