Nursing Open最新文献

Aims: To examine the associations among illness perception, resignation coping, social support, and self-regulatory fatigue (SRF) in patients with Type 2 diabetes mellitus. The study specifically explores whether resignation coping and social support exhibit indirect associations with SRF in the context of illness perception.

Design: A cross-sectional study.

Methods: From November 2024 to October 2025, a convenience sample of 302 adult patients with T2DM was recruited from a tertiary general hospital in China. Participants completed validated instruments with established psychometric properties, namely the Brief Illness Perception Questionnaire, the Medical Coping Modes Questionnaire, the Perceived Social Support Scale, and the Self-Regulatory Fatigue Scale. Statistical analyses included Spearman correlation and serial mediation analysis using the PROCESS Macro (Model 6) with bias-corrected bootstrapping.

Results: SRF was positively correlated with negative illness perception (r = 0.579, p < 0.01) and resignation coping (r = 0.612, p < 0.01), and negatively correlated with social support (r = -0.598, p < 0.01). Serial mediation analysis revealed that illness perception was associated with SRF through indirect pathways involving resignation coping and social support. Resignation coping and social support mediated the association between illness perception and self-regulatory fatigue, both individually and sequentially.

Conclusions: Negative illness perception correlates with higher SRF. This observed correlation is additionally linked to indirect pathways involving resignation coping and lower social support. Collectively, these findings highlight a pattern of interrelated cognitive (illness perception), behavioural (resignation coping), and resource (social support) factors that are associated with self-regulatory fatigue in this cross-sectional study.

Implications for the profession: The findings offer a clear, evidence-based framework for nursing practice. They highlight the potential value of integrated assessment and intervention that simultaneously addresses patients' illness beliefs, maladaptive coping strategies, and social support systems, which are associated with lower SRF and better diabetes self-management.

Reporting method: This study adheres to the Strengthening the Reporting of Observational Studies in Epidemiology (STROBE) guidelines for cross-sectional studies.

Patient or public contribution: Patients participated solely as research participants by providing survey data. They were not involved in the study design, implementation, data analysis, interpretation, or manuscript preparation. All patients provided written informed consent prior to questionnaire completion.

Aims: To summarise and synthesise extant research studies that identify risk factors for the development of postpartum weight retention in postpartum women.

Design: Integrative review.

Review methods: This review was guided by Whittemore and Knafl's methodology. Eleven databases were searched for relevant original studies from database creation to November 25, 2025. Two researchers independently screened articles against the predefined inclusion and exclusion criteria, extracted data, and assessed the quality of the included studies using the Newcastle-Ottawa Scale. Descriptive summaries and graphical representations were produced for the findings. PROSPERO registration number: CRD42024530948.

Results: Of 2750 retrieved sources, 26 studies were included in this review. The existing measurement approach failed to assess postpartum weight retention precisely. Overall study quality was moderate (n = 16), with seven rated as high quality and three as low quality. Risk factors for postpartum weight retention were categorised into three themes, nine subthemes, and 21 risk factors according to the Andersen model, most of which are modifiable.

Conclusion: The accuracy of postpartum weight retention measurement approaches needs to be examined to provide reliable data. The incidence of postpartum weight retention is unsatisfactory, especially for women in upper-middle-income countries. Designing a comprehensive and evidence-based health management strategy will support minimising risk factors of postpartum weight retention, and high-quality empirical studies could be conducted to refine the theoretical framework for postpartum weight retention.

Implications for nursing practice: This study suggests that nursing managers should strengthen education and training for nurses, midwives, and postpartum care providers regarding postpartum weight management and regularly assess their ability to evaluate postpartum weight and identify risk factors for postpartum weight retention. These findings may also serve as a reference for nursing researchers in developing risk assessment instruments for postpartum weight retention and optimising predictive models.

Reporting method: This review was conducted by following the PRISMA 2020 guidelines for reporting systematic reviews.

Patient or public contribution: No patient or public contribution.

Aim: Premature infants require interventions supporting comfort in the NICU and development after discharge. Therefore, this study examined the effects of maternal affectionate touch and lullaby singing on early comfort and of a developmental support programme on subsequent development.

Design: This randomized controlled experimental study included 57 premature infants in a neonatal intensive care unit: 27 in the intervention group and 30 in the control group.

Methods: Mothers in the intervention group provided lullaby singing and affectionate touch three times weekly for at least six 10-min sessions. From 40 weeks' gestation, they implemented the developmental support programme, and infant development was assessed monthly for 3 months. The Premature Infant Comfort Scale and Developmental Support Programme Evaluation Form were used.

Results: Sex distribution was 8/19 girls/boys (29.6%/70.4%) in the intervention group and 16/14 (53.3%/46.7%) in the control group. Post-intervention PICS scores were significantly lower in the intervention group in weeks 1, 2, and 4 (p = 0.032, p < 0.001, and p = 0.047, respectively). At 1 month, social-emotional development (p = 0.028), receptive language (p = 0.005-0.009), productive language (p = 0.002), and cognitive skills (p = 0.004) were significantly higher in the intervention group. Receptive language at 2 months (p = 0.028) and cognitive development at 3 months (p = 0.033) also favoured the intervention group. In the BH-FDR sensitivity analysis, only the Week 2 post-intervention PICS difference (adjusted p = 0.012) and the first-month PLS-4 language finding (adjusted p = 0.040) remained statistically significant; the first-month RLS-3 finding was at the threshold of statistical significance (adjusted p = 0.050).

Recommendations: Maternal lullaby singing, affectionate touch, and developmental support may support comfort and early developmental follow-up in premature infants; however, findings should be confirmed in larger studies with longer follow-up.

Patient or public contribution: Mothers participated voluntarily and devoted sufficient time to each stage of the study.

Trial registration: ClinicalTrials.gov identifier: NCT06191757.

Aim: To examine whether recovery experiences and need for recovery mediate the association between psychological capital and perceived stress in nurses.

Design: Cross-sectional online survey.

Methods: A total of 184 nurses currently practicing in France completed an anonymous online questionnaire administered in January 2023. Participants completed the French versions of the Psychological Capital Questionnaire, the Recovery Experience Scale, the Need for Recovery Scale, and the Perceived Stress Scale. Two mediation models were estimated using ordinary least squares regression with percentile bootstrap inference for the indirect effects.

Results: Psychological capital was positively associated with recovery experiences and negatively associated with need for recovery. Need for recovery was strongly and positively associated with perceived stress, while psychological capital showed no direct association with perceived stress. The indirect effect of psychological capital on perceived stress through need for recovery was statistically detectable, whereas a complementary indirect effect through recovery experiences was in the expected direction but did not meet the bootstrap criterion for statistical significance.

Conclusion: In this cross-sectional sample, psychological capital was associated with lower perceived stress primarily through its association with reduced need for recovery rather than through a direct association with stress. Interventions intended to protect nurse well-being should therefore be conceived as combining individual resource-building with organizational architectures that enable effective recovery.

Implication for nursing practice: Psychological capital should be seen as one element in integrated interventions rather than a stand-alone solution to nursing stress. Brief recovery-focused interventions for nurses need to be combined with scheduling practices and organizational policies that protect rest and make recovery feasible, a configuration that appears more promising than psychological capital training alone.

Reporting method: The study followed the STROBE Statement for the reporting of cross-sectional studies.

No patient or public contribution: This study focused on nurses as study participants. No patient or public stakeholder was involved in the design, conduct, or interpretation of the research, since the research question concerns occupational psychological resources rather than clinical practice or care delivery.

Aim: To investigate the symptom burden associated with MPNs and its impact on patients' psychophysical well-being and quality of life through a structured PROM-based nurse-led visit.

Design: Observational study.

Methods: We included MPN patients followed at the haematology outpatient clinic of a large university-affiliated hospital in Italy. Data were collected from September 2024 to March 2025 on 102 patients who underwent a structured PROM-based nurse-led visit supported by a dedicated symptom diary.

Results: Symptom burden was substantial (85% were symptomatic) across all disease subtypes, with fatigue emerging as the most prominent symptom, affecting 72% of patients and accompanied by marked psychological distress (42% and 44% with anxious and depressive symptoms, respectively). Overall health-related quality of life was predominantly moderate (mean score: 70.7 ± 21.3). Nearly all moderate-to-severe symptoms, including fatigue, inactivity, pain, itching, and abdominal discomfort, were strongly associated with impaired global health. 43% of patients need support in becoming more proactive in managing their disease, and satisfaction with the visit was very high (mean score 9.3 ± 1.3/10).

Conclusion: The impact of MPNs was significant and multifaceted, affecting patients' physical, emotional, and social well-being. Structured PROM-based nurse-led visits play a key role in detecting patients' needs and supporting symptom management across all domains of well-being, fostering motivated engagement.

Implications for the profession and patient care: Integrating structured PROM-based nurse-led visits into routine haematology care may improve symptom monitoring, support patient engagement, and guide timely and tailored supportive interventions.

Impact: Patients with MPNs experience a substantial physical and psychosocial symptom burden. Symptom clusters are associated with anxiety, depression, and reduced quality of life. Structured PROM-based nurse-led visits may facilitate the early identification of unmet supportive care needs.

Reporting method: Guidelines for reporting observational studies (STROBE): PATIENT CONTRIBUTION: Patients actively participated during the nurse-led visit and in data collection.

Aim: This cross-sectional study examined the associations between short video exposure, nursing students' empathy, and attitudes toward end-of-life (EOL) care, and tested whether perceived impact is statistically consistent with an indirect pathway in these relationships.

Design: A descriptive cross-sectional study.

Methods: In total, 534 undergraduate nursing students were included. Data were collected using a self-designed questionnaire, including the Attitudes Toward Care of the Dying Scale and the Jefferson Scale of Empathy-Health Professions Student version for empathy assessment. Statistical analysis for correlation and mediation analysis (PROCESS macro) was performed.

Results: 85.96% of students watch short videos for more than 30 min daily, with more than 60% of them viewing EOL-related content. Students with prior caregiving experience or formal palliative care education showed significantly higher empathy and more positive attitudes (p < 0.05). Exposure to medical and EOL-related short videos was positively correlated with perceived impact, empathy, and positive EOL attitudes, with effect sizes ranging from very weak to modest (r = 0.10 to 0.27). The data were consistent with an indirect pathway between short video exposure and empathy via perceived impact (indirect effect = 0.04; 95% bootstrap CI [0.01, 0.08]). However, for EOL attitudes, short video exposure showed a direct association rather than an indirect pathway via perceived impact (direct effect = 0.09, p < 0.01).

Conclusion: In this cross-sectional study, short video exposure was modestly associated with nursing students' empathy, with data consistent with an indirect pathway via perceived impact; the observed associations explained only approximately 1% to 7% of the variance in the outcome variables. However, reshaping EOL attitudes may require more systematic education beyond brief video exposure. These findings are hypothesis-generating and await validation through longitudinal and experimental research using standardized video content.

Implications for nursing practice: Nursing educators should consider integrating curated short video content into palliative care curricula to enhance students' empathy and perceived impact of end-of-life education. However, brief video exposure alone may be insufficient to reshape deeper end-of-life attitudes, suggesting the need for comprehensive, multi-modal educational strategies.

Aim: This study aimed to determine whether midwifery students' awareness of global climate change is associated with their attitudes and behaviours toward medical waste management.

Design: This study employed a descriptive cross-sectional design.

Methods: The study was conducted during the 2025-2026 academic year at Atatürk University. The sample consisted of volunteer midwifery students enrolled across all academic years. Data were collected using a sociodemographic questionnaire, the Global Climate Change Awareness Scale and the Medical Waste Attitude and Behaviour Scale. Data were analysed using descriptive statistics, independent samples t-tests, one-way ANOVA with Bonferroni post hoc tests and Pearson correlation analysis.

Results: Participants demonstrated high levels of climate change awareness (74.60 ± 8.21) and generally positive attitudes toward medical waste management (96.91 ± 12.10). Fourth-year students had significantly higher awareness scores than students in lower academic years (p < 0.05). Students who perceived climate change as a professional responsibility and believed that it affected health had significantly higher climate change awareness scores. A moderate positive correlation was identified between climate change awareness and medical waste attitudes (r = 0.392, p < 0.001).

Implications for nursing practice: Nurse educators should integrate climate change, environmental sustainability and medical waste management into undergraduate nursing and midwifery curricula using evidence-based educational strategies. Strengthening students' environmental competencies may promote sustainable healthcare practices, improve waste management behaviours and prepare future healthcare professionals to address the environmental challenges associated with climate change.

No patient or public contribution: No patient or public contribution.

Aim: To compare the effectiveness of simulation-based education (alone or in combination with patient-based clinical teaching) in undergraduate nursing students, when measured using objectively assessed outcomes.

Design: Systematic review with meta-analyses.

Review methods: Comparative studies in undergraduate nurses where outcomes of externally verified exams, proficiencies or competencies for both groups were included. Citation-checking, data-extraction and quality-assessment (using CASP checklists) were by two reviewers independently, and Revman (5.4) was used for meta-analysis, using standardised mean differences (SMD).

Data sources: Ten databases (platforms) were searched from January 2000 to January 2024: MEDLINE (OVID), Embase (OVID), Maternity and Childcare (OVID), CINAHL (EBSCO), PsycINFO (EBSCO), Central (Cochrane Library), Scopus, Science Citation Index (Web of Science), ERIC (EBSCO) and Assia (ProQuest).

Results: Forty-two studies (5336 participants) were included: 19 randomised controlled trials, two randomised crossover trials, three cohort and 18 case-control studies. Twenty-eight studies compared simulation-based education to clinical teaching, 11 compared simulation-based education plus clinical teaching to clinical teaching only, and three compared more versus less simulation-based education in courses. Comparison 1: 21 studies (n = 2329 participants) could be meta-analysed, giving SMD = 0.96 (95% confidence intervals = 0.63-1.30). Comparison 2: 11 studies (n = 918 participants) gave SMD = 0.82 (95% confidence intervals = 0.49-1.15). All included studies reported as good or better results for simulation education.

Conclusions: Simulation-based education, alone or in combination, may be as good as patient-based clinical teaching only to teach care skills to nursing students. Future simulation-based education versus patient-based clinical teaching evaluations should also measure clinical and patient-based outcomes.

Implications for the profession and/or patient care: More simulation-based education of nursing students may result in fewer patients used for teaching.

Impact: Increased simulation-based education may enhance undergraduate teaching, as more can be taught patient-based clinical skills in an educational setting without apparently reducing educational performance.

Patient or public contribution: No patient or public contribution as this is a systematic review.

Trial registration: PROSPERO (https://www.crd.york.ac.uk/prospero): CRD42022363205.