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Mentoring in nursing is crucial for supporting newly qualified nurses, enhancing retention and promoting professional development. Despite its significance, limited research has explored nurse mentors' perspectives and their own development through mentoring. To explore how a structured mentoring intervention influences nurse mentors' clinical teaching behaviour, self-efficacy and experiences of their professional role development. A convergent mixed-methods study was conducted during a mentorship intervention across healthcare units in hospitals and municipalities in northern Sweden and Norway. Forty-one experienced registered nurses participated as nurse mentors. Quantitative data were collected via validated instruments on clinical teaching behaviour and self-efficacy before and twice after the intervention. Qualitative data were collected through post-intervention focus group interviews. Quantitative data were analysed using Wilcoxon signed rank test; qualitative data were analysed using qualitative content analysis. Findings were triangulated to identify convergence and divergence. Nurse mentors reported personal and professional growth, especially in relationship-building, mentoring skills and role clarity. Results showed consistently high ratings in clinical teaching behaviour and self-efficacy, with an increase in clinical teaching behaviour scores post-intervention. Structured mentoring interventions support nurse mentors' development, improving clinical teaching practices and reinforcing their professional identity-key factors in nurse retention. The findings highlight the need for sustained nurse mentor support and tailored mentorship frameworks to ensure effective, long-term mentoring in nursing. What problem did the study address? Mentoring is essential for supporting newly qualified nurses, improving retention and fostering their professional development. Most mentorship research focuses on mentees, with limited insight into nurse mentors' perspectives and development. What were the main findings? Nurse mentors experienced development in several areas throughout the intervention, particularly in building relationships, fostering meaningful mentoring skills and refining their role as nurse mentors. Where and on whom will the research have an impact? This study can inform policy and practice by contributing knowledge on the development of sustainable mentoring frameworks. These frameworks support the formation of collaborative and stable work groups in clinical settings, enhancing nurse retention, professional development and the overall quality of patient care. This study adhered to the Good Reporting of A Mixed Methods Study (GRAMMS) guidelines, by O'cathain et al. as recommended by the EQUATOR network. No patient or public contribution.

Inhaled therapy is critical for treating chronic airway diseases, yet the competency of respiratory nurses in providing guidance remains inconsistent. Few studies have explored the systemic competency disparities that are driven by a hierarchical distribution of healthcare resources. The aim of this study is to assess self-reported inhaled therapy guidance (ITG) competency among respiratory nurses across multiple-tier healthcare institutions, as well as to explore factors that affected such competency. A total of 962 respiratory nurses at multilevel hospitals in Jiangsu Province, Eastern China were investigated. We developed an ITG competency scale and evaluated its reliability and validity. Nurses rated themselves on a structured questionnaire that was designed to collect data on ITG competency in this population. The associated factors were determined using a descriptive statistical analysis, a correlation analysis, and a hierarchical multiple regression analysis. We followed the Strengthening the Reporting of Observational Studies in Epidemiology (STROBE) checklist for cross-sectional studies. The ITG competency average score for respiratory nurses was (73.90&#x202f;&#xb1;&#x202f;9.42). Significant competency disparities were observed across all hospital tiers (p&#x202f;<&#x202f;0.001), with the primary hospitals demonstrating higher rates of poor and lower proportions of good ratings than secondary/tertiary hospitals. For the knowledge dimension, tertiary hospitals had the fewest poor ratings, while primary hospitals exhibited the highest prevalence of poor ratings, although the proportion of good skill ratings remained comparable across all tiers (p&#x202f;>&#x202f;0.05). Educational attainment, hospital grade, and training methodologies were associated with respiratory nurses' competency at ITG. The respiratory nurses exhibited moderate levels of ITG competency, with a notable gap between their knowledge and skills. This gap was more pronounced in primary hospitals, suggesting an association with institutional resource contexts. These results highlight the need for training strategies tailored to each hospital tier, as well as enhanced resource support from tertiary centers to primary care. This would help promote more standardized training programs and reduce competency disparities across hospital tiers.

The globalisation of the healthcare workforce has led to a growing proportion of Internationally Educated Nurses within health care organisations. While their contributions are invaluable, many face challenges in adapting to new professional environments, highlighting the urgent need for organisations to implement evidence-based strategies to support their successful integration. The aim of this review was to identify and describe workplace support strategies shown to be helpful in supporting Internationally Educated Nurses from non-English-speaking backgrounds transitioning into the Western healthcare workforce. A systematic review was conducted including primary research studies reporting qualitative and/or quantitative data. The population of interest was Internationally Educated Nurses from non-English speaking backgrounds who were employed in Western health care settings including Australia, New Zealand, Canada, United States of America and the United Kingdom. The intervention of interest was strategies that could be put in place by the workplace to improve outcomes for the nurse or the workplace. Three databases (Medline, PsycInfo, CINAHL) and grey literature were searched in November 2024. Risk of bias was assessed using corresponding tools from the Joanna Briggs Institute. Results were tabulated and presented in a narrative synthesis. A total of 20 studies were included with most (n&#x2009;=&#x2009;13) being qualitative. Studies were conducted in a range of countries with nurses from a range of different cultural backgrounds. Nine key approaches were identified to support successful integration, spanning organisational strategies (e.g., anti-racism policies and equitable career pathways), educational programs on cultural competence for all nurses, and structural supports such as tailored orientation and mentoring. We were unable to identify any experimental studies which provided quantitative data on the effects of strategies to support Internationally Educated Nurses. The included studies provided information about a range of different ways to enhance transition. Not applicable.

This study aimed to assess the levels of psychological capital, job crafting, and innovative behavior among operating room nurses and to examine the mediating mechanism of job crafting in the relationship between psychological capital and innovative behavior. A multicenter cross-sectional study was conducted. In June 2025, a total of 361 operating room nurses from six tertiary hospitals in Nanjing, China, were recruited via convenience sampling. Data were collected electronically using validated scales: Demographic Questionnaire, the Psychological Capital Questionnaire, the Job Crafting Scale, and the Nurse Innovative Behavior Scale. Data were analyzed using SPSS 26.0 and AMOS 28.0. Structural equation modeling with bootstrapping tested the mediation model, controlling for educational level and specialist nurse status. Participants reported moderate-to-high levels of psychological capital, job crafting, and innovative behavior. Correlation analysis revealed that innovative behavior was significantly and positively correlated with both psychological capital and job crafting. Hierarchical regression analysis, controlling for significant covariates, showed that both psychological capital and job crafting contributed significantly to the variance in innovative behavior. Mediation analysis demonstrated that job crafting partially mediated the relationship between psychological capital and innovative behavior. Operating room nurses reported moderately high levels of psychological capital, job crafting, and innovative behavior. Furthermore, job crafting was identified as a significant partial mediator in the relationship between psychological capital and innovative behavior. Nursing management can foster innovation in operating room nurses by developing psychological capital and job crafting skills through targeted training and academic support.

BackgroundDigital technologies are reshaping leadership in nursing, making it essential to understand how digital leadership relates to attitudes toward artificial intelligence in nursing.ObjectiveThis study was conducted to determine the effects of the digital leadership characteristics of manager nurses on their general attitudes toward artificial intelligence.MethodsThis study was conducted with a cross-sectional design, and its results are reported using the STROBE checklist. The population of the study included manager nurses who were working at a University Hospital in Eastern T&#xfc;rkiye (N&#x2009;=&#x2009;133). Data were collected using a "Personal Information Form", the "Digital Leadership Scale", and the "General Attitudes towards Artificial Intelligence Scale". Descriptive statistics were used in the analysis of the data, and comparisons in independent groups were made using the "Mann-Whitney U" test for two groups and the "Kruskal-Wallis" test for more than two groups. Pearson's correlation analysis was performed to determine the relationship between the independent and dependent variables. A simple linear regression analysis was performed with the Enter model to determine the effect of the independent variable on the dependent variable. A confirmatory factor analysis was performed to determine whether the scales used were suitable for the sample of manager nurses. As a result of the analysis, it was determined that the scales used were appropriate for use in the sample.ResultsThe participants of the study had moderate levels of digital leadership and above-moderate levels of positive attitudes toward artificial intelligence. It was found that the digital leadership characteristics of the participants were significantly effective on their general attitudes toward artificial intelligence.ConclusionsThe usage of artificial intelligence and digital technologies by manager nurses during the provision of healthcare services will result in their adoption of a position as role models and good leaders for their nurse colleagues, improve their capacity to organize routine practices and treatment processes at the clinic, and increase the quality of nursing care by helping nurses make better decisions. It is thought that the use of some practices in the workplace with digital transformations, such as artificial intelligence, will have positive effects on employee well-being, job satisfaction, and workforce adaptation, including the reduction of workload and the prevention of loss of workforce and time.

To examine the association between perceived organizational support (POS) and nurses' caring behaviors and to explore the serial mediating roles of perceived stress and career calling (CALL) in this relationship. Caring behaviors are essential for high-quality nursing care and patient satisfaction. However, heavy workloads and psychological pressure may weaken nurses' caring performance. POS, as a key job resource, may be associated with caring behaviors alongside lower perceived stress and stronger intrinsic motivation, such as CALL. A cross-sectional survey was conducted among 648 nurses from six tertiary hospitals in Chongqing, China. Standardized questionnaires were used to assess POS, perceived stress, CALL, and caring behaviors. The hypothesized serial mediation model was tested using structural equation modeling (SEM) with bias-corrected bootstrapping, and additional PROCESS analysis was performed to verify robustness. Organizational support was positively associated with caring behaviors (&#x3b2;&#x2009;=&#x2009;0.33, p < 0.001), and a significant indirect association via perceived stress and CALL (&#x3b2;&#x2009;=&#x2009;0.12, 95% CI [0.07, 0.24]). The model explained 26% of the variance in caring behaviors (R2&#x2009;=&#x2009;0.26), and the indirect path accounted for about 26.7% of the total effect. Findings were consistent in PROCESS analyses and were in line with the hypothesized serial mediation model. POS was associated with nurses' caring behaviors, both directly and through an indirect pathway involving perceived stress and CALL. These findings suggest that perceived stress and CALL may represent potential pathways linking organizational support with caring behaviors. Nurse managers may consider fostering supportive organizational environments, implementing stress management interventions, and developing programs that help strengthen nurses' CALL, as these factors may be associated with more favorable caring behaviors and nursing practice.

Nursing work in several Western countries has been affected by evolving discourses of managerialism and professionalism. Interdisciplinary working has given nurses more prominence in high-level teams and created hybrid management roles that have affected understandings of professionalism. Such changes generally followed broader new public management (NPM) reforms that shifted power from senior doctors to executive managers. Yet, although there is an extensive literature on the global spread of NPM reforms, less is known about the influence of associated discourses concerning nurse management and professionalism. This paper addresses that gap by presenting qualitative data on the evolving situation of hospital nursing in T&#xfc;rkiye, a country that implemented NPM-type reforms in the early 2000s. Based on 40 in-depth interviews completed in 2021/22, it describes the uneven impact of these reforms on medicine and nursing, the continuing reality of medical dominance and the development of a professionalising project among Turkish hospital nurses that avoids directly challenging medical power. This emphasises continuing professional education, practice guideline development and a curtailed form of teamwork away from doctors. Nurses exercised greatest autonomy in specialised wards, intensive care units and emergency departments, where a stable staff group could operate at a distance from oversight by senior doctors.

Delirium is a multifactorial and potentially life-threatening syndrome that remains underdiagnosed and undertreated in nursing homes, despite residents' high vulnerability due to advanced age, multimorbidity and cognitive impairment. To date, little is known how healthcare professionals perceive and manage delirium in these settings, particularly regarding prevention, diagnosis, therapy and interdisciplinary collaboration, as well as differentiation from other neurodegenerative diseases. This study explores the perspectives of nurses and general practitioners (GPs) on the quality of delirium care in German nursing homes in order to identify barriers and opportunities for improvement. An exploratory qualitative design was employed. A total of 30 semi-structured interviews were conducted with 15 nurses and 15 GPs in Germany. Participants were recruited using a criterion-based purposive sampling strategy to ensure their direct involvement in nursing home care. Data were collected using collaboratively developed interview guides and analyzed using qualitative content analysis with a deductive-inductive approach. Both nurses and GPs reported uncertainty and variability in the understanding, recognition and management of delirium in nursing homes. While preventive and other non-pharmacological measures were applied intuitively, they were rarely identified as delirium-specific. Both professions highlighted limited knowledge and training, unclear responsibilities and the absence of standardized tools as major barriers to effective care. Diagnostic practices were largely based on clinical impression rather than structured assessments. Interprofessional and interdisciplinary cooperation was considered essential but was often hindered by organizational factors and individual attitudes. Participants also emphasized the value of involving relatives and other significant others in the care process but noted that this was inconsistent. Delirium care in German nursing homes is non-standardized and marked by substantial variability in practice and outcomes. Although individual nurses and GPs recognize the challenges and apply some effective routines intuitively, care remains insufficiently systematic and rarely guided by standardized strategies in general. Addressing knowledge gaps, improving interprofessional communication and implementing structured care pathways are crucial steps toward enhancing the prevention, diagnosis and therapy of delirium in these settings.

To investigate coping strategies and associated factors among clinical nurses in Iran in 2023. Cross-sectional study. Hospitals in Kashan, Iran. A total of 400 nurses were selected through stratified random sampling from different hospital departments. Coping strategies were measured via the Potential Factors Related to Coping Strategies Questionnaire, the Work-Family Conflict Scale and the Ways of Coping Questionnaire. Coping strategies were quantified with scores ranging from 0 to 198. Associations with potential influencing factors were assessed. The coping strategies score was 94.22&#xb1;25.49 (95% CLM 91.72 to 96.72). Notably, 83.5% of the variation in coping strategy scores could be attributed to emotion-focused coping. The simultaneous inclusion of work-family conflict and spouse participation in household affairs was found to be significant (F=9.85, p<0.0001). Work-family conflict was positively associated (B=0.82, 95%&#x2009;CI 0.38 to 1.26), whereas spouse participation was negatively associated (B=-8.43, 95%&#x2009;CI -16.22 to -0.64). Together, these variables accounted for 6.4% of the variance in coping strategies. Nurses in Kashan hospitals used moderate levels of coping strategies, which were mainly emotion-focused. It is recommended that hospitals provide guidance on these strategies, especially during pandemic crises.

Neuroscience nurses need clinical competence (CC) when taking care of neuropatients. In this study the selected nursing context is inpatient wards and intensive care units (ICU) in university hospitals and tertiary referral centers where neuroscience patients are treated 24/7, patients' conditions can change rapidly, and nurses execute clinical interventions continually for adult patients. The aim was to describe and synthesize the available information on the types of CC needed in neuroscience nursing (NSN) and to describe how the competencies are or should be ensured. A mixed-method systematic review of literature from 2014 to 2024. Descriptive qualitative and quantitative studies were included in a convergent integrated approach. Qualitative synthesis was conducted through thematic inductive analysis of the combined data. Twenty studies met the inclusion criteria. CC in NSN in inpatient wards and ICUs was categorized into four main categories: neurospecific interventions, core nursing interventions, psychosocial interventions, and ensuring the quality and safety of patient care. Regarding how CC is ensured in clinical practice, the categories were postgraduate education, training sessions and feedback, extensive work experience and belonging to a neuroscience work community, and evidence-based materials and protocols. In terms of recommendations for ensuring CC, the categories identified were education and training in varying facilities, increasing knowledge and theoretical basis, and local opinion leaders, and the use of standardized tools. NSN requires specific and general CC in executing nursing interventions in hospital inpatients wards and ICUs. CC in NSN is ensured through various methods, and it will remain important to ensure and assess nurses' competence to deliver high-quality and safe nursing care. This review emphasized the need to evaluate the CC of NSN in clinical practice.

There is a lack of long-term outcome data supporting the role of nurses in cardiovascular (CV) risk management. The ALLEPRE [ALLiance for sEcondary PREvention after an acute coronary syndrome (ACS)] trial was a pragmatic, randomized, multicentre, interventional trial comparing the efficacy of a nurse-coordinated prevention program (NCPP) with standard of care (SOC). The NCPP patients attended nine individual educational sessions over four years at which a centrally trained nurse provided counselling aimed at identifying CV risk factors and encouraging healthier lifestyles and medication adherence; the SOC patients followed the standard practices of their hospitals. The trial's primary endpoint was the composite of CV death, non-fatal myocardial infarction (MI), and non-fatal stroke (MACE). A total of 2057 ACS patients were randomized 1:1 to the NCCP (n=1031) or SOC group (n=1026). In comparison with SOC, the NCPP significantly reduced MACE [16.2% vs 22.6%; hazard ratio (HR) 0.70; 95% confidence interval (CI) 0.57-0.85; P-value <0.001], a benefit mainly driven by a reduction in non-fatal MI (9.3% vs 15.2%; HR 0.60; 95% CI 0.46-0.77; P-value=0.0001). The occurrence of the pre-specified secondary outcome of MACE plus ischaemia-driven revascularization was significantly reduced (HR 0.77, 95% CI 0.64-0.92; P-value= 0.005). Exercise frequency (P<0.0001), body weight control (P=0.003), and medication adherence (P<0.001) improved more in the NCPP group. The NCPP significantly reduced long-term MACE, improved physical activity, body weight control, and pharmacotherapy adherence in post-hospitalization ACS patients. Including an NCPP in healthcare provision may contribute to the successful implementation of secondary prevention strategies.

Introduction/ObjectivesSDOH screening is increasingly required, yet is often operationalized as EHR documentation. The objective of this project was to explore how social workers and nurse case managers experience SDOH screening and how care settings shape its meaning and practice.MethodsWe conducted semi-structured interviews with 10 staff members (6 social workers, 4 nurse case managers) across inpatient and outpatient follow-up contexts in a large academic health system and analyzed transcripts using Colaizzi's phenomenological method.ResultsFive themes emerged: negotiating patient autonomy, conversational personalization, technological and systemic frustrations, staff expertise, and interprofessional collaboration. Participants reported time pressure, emotional labor, and moral distress when needs were identified without reliable pathways to assistance, and they described contrasting inpatient urgency and outpatient continuity that influenced disclosure, trust, and follow-up.ConclusionsSDOH screening was experienced as relationship-centered work that depends on supportive workflows and response capacity; implementation should pair screening mandates with training, streamlined documentation, and closed-loop referral processes.

Doctors, nurses, and midwives are key providers of abortion care for women in Australia. Providing abortion care is a challenging, contentious, and sometimes perilous occupation. Recent changes in the Australian abortion care landscape mean that it is essential to consider the experiences and perceptions of the abortion workforce and to identify future needs. The aim of this review was to collate and report the experiences and perceptions of doctors, nurses, and midwives who provide abortion care in Australia. A scoping review was utilised to address this question, applying Arksey and O'Malley's framework with enhancements by Levac et&#xa0;al. Research question development and reporting approaches were informed by Joanna Briggs Institute (JBI) Health. In total, 19 articles were included in the review. Studies were predominantly qualitative in nature and encompassed all three clinical groups. Most studies included participants from multiple Australian sites, with five focusing specifically on Victorian participants. Overarching themes included: clinical care provision; person-centred care; social and system-based factors; provider education, training and networks; abortion and the law; ethical challenges; emotional responses; abortion stigma; and conscientious objection. The experiences of Australian abortion providers reflect shared challenges relating to: training access; ethical and emotional impacts; abortion stigma; and conscientious objection. Navigating changing system, regulatory, and legal frameworks compounds this complexity. Further research into the experiences of abortion providers will inform support interventions. Legislators, regulators, and health service executives must listen to the needs of providers to ensure service sustainability into the future.

Intrinsic capacity (IC) has shown potential in predicting health outcomes in older adults. However, its prognostic value in patients with coronary artery disease (CAD) following percutaneous coronary intervention (PCI) has not been established. In this retrospective cohort study, patients with CAD undergoing PCI were included. IC score was assessed within 48&#x2005;h of admission using a structured nurse-administered questionnaire. The primary outcome was all-cause rehospitalization. Secondary outcomes included cardiovascular rehospitalization and non-cardiovascular rehospitalization. Kaplan-Meier analysis, Cox proportional hazards models, and restricted cubic spline (RCS) were used to estimate the relation between IC score and rehospitalization. Subgroup analysis and receiver operating characteristic (ROC) curves were used to assess predictive performance. A higher IC score, indicating poorer IC, was independently associated with increased all-cause rehospitalization risk (HR&#x2009;=&#x2009;3.07 for IC&#x2009;=&#x2009;4 compared with IC&#x2009;=&#x2009;0, 95% CI 1.89-5.00) and cardiovascular rehospitalization risk (HR&#x2009;=&#x2009;5.23 for IC&#x2009;=&#x2009;4 compared with IC&#x2009;=&#x2009;0, 95% CI 2.30-11.89). Subgroup analyses showed that this relationship remained consistent across lesion morphologies and revascularization strategies. In contrast, IC score was not a significant predictor of non-cardiovascular rehospitalization. RCS curves showed the linear positive relationship between IC score and HR of cardiac rehospitalization with the cutoff of 2.5. ROC curve for all-cause rehospitalization showed IC score with the AUC of 0.692 (95% CI: 0.664-0.729). IC score is an accessible, independent, and robust predictor of cardiovascular rehospitalization after PCI in CAD patients.

This letter responds to the essay "What Does Moral Agency Mean for Nurses in the Era of Artificial Intelligence?," by Connie M. Ulrich, Oonjee Oh, Sang Bin You, Maxim Topaz, Zahra Rahemi, Liz Stokes, Lisiane Pruinelli, George Demiris, and Patricia Flatley Brennan, in the January-February 2026 issue of the Hastings Center Report.

Medical conferences and educational courses in gastrointestinal (GI) endoscopy are essential for training, quality improvement, and scientific exchange, but they are also associated with a substantial environmental footprint, largely driven by travel-related greenhouse gas emissions and resource consumption. While sustainability in endoscopic practice has gained increasing attention, the environmental impact of endoscopy congresses and courses has remained insufficiently addressed. This document outlines the official position of the European Society of Gastrointestinal Endoscopy (ESGE) and the European Society of Gastroenterology and Endoscopy Nurses and Associates (ESGENA). An international multidisciplinary panel of experts conducted a systematic literature review, expert narrative appraisal where evidence was limited, and an iterative Delphi consensus process. The resulting recommendations address key domains of conference organization, including event conception, scientific program design, transportation and participation models, faculty selection, venue and accommodation, catering, waste reduction, training formats, and collaboration with industry partners. Emphasis is placed on promoting virtual and hybrid conference formats, low-emission travel options, sustainable venues and catering, and the systematic measurement and transparent reporting of environmental impact. This ESGE-ESGENA Position Statement provides practical, consensus-based, evidence-informed guidance to support GI endoscopy societies, conference organizers, industry partners, and participants in reducing the environmental impact of endoscopy-related educational activities while preserving their scientific and educational quality.

Addressing the demands of an ageing population requires a shift from individualised to collective prevention. Collective prevention adopts a socio-ecological approach, mobilising communities to improve population health. This study explores community nurses' (CNs) perceptions of their role as health promoters. A qualitative study using participatory action research was conducted among 58 CNs from 18 community nursing care teams over 3&#x2009;years. Data collection included 11 focus groups, a World Caf&#xe9; session, and participant observations. Data were analysed through iterative thematic content analysis. From the analysis, 3 themes emerged: (1) CNs understanding of prevention, (2) their views on their roles and competencies, and (3)what are the facilitating and hindering factors to implement collective prevention. CNs' understanding of prevention evolved from individual "aversion" of disease to a community-based vision centred on social connection. Four key roles for CNs were identified: detector, motivator, facilitator, and organiser. While a shared vision within teams facilitated progress, significant barriers included time pressure, productivity-based funding, and a lack of training in nursing curricula. CNs role in collective prevention is important, transitioning from task-oriented nursing care to community empowerment. However, sustainable implementation requires integrating collective prevention into national policy funding, and nursing education.

Children's health-related quality of life (HRQoL) varies in their country's conditions, with physical and mental well-being challenges being more prevalent in low- and middle-income countries. This study aimed to improve children's HRQoL through the school nurse program in Bangladesh. A nonrandomized controlled trial with a pre- and posttest design was conducted in Bangladesh. A total of 455 primary schoolchildren consented to enroll and completed the entire study, and their data were analyzed. Children were allocated into the control group (CG; n = 220) and the intervention group (IG; n = 235). Regarding household characteristics, most participants did not use water purification methods in both the groups (CG = 71.8% and IG = 73.2%). Subsequently, they had poor accessibility to handwashing facilities (CG = 39.5% and IG = 33.6%), with limited or no access to handwashing facilities. To explore the study's primary outcome, a t -test was used to compare the difference in HRQoL from endline to baseline between CG (mean = 25.12, standard deviation [SD] = 21.99) and IG (mean = 26.47, SD = 25.48), which showed no statistically significant difference between the groups ( P = 0.549). Furthermore, the T -score of HRQoL was improved chronologically in the IG compared with the CG. Although children's HRQoL is influenced by various factors, it could be enhanced by an effective and sustainable school health program. Therefore, a collaborative initiative from the government and nongovernmental organizations is required to secure better HRQoL for children.