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Night shift work is known to disrupt circadian rhythms, leading to significant physical and mental health challenges, including fatigue, sleep deprivation, and long-term health risks. For nurses working the night shift, these factors compromise both their own well-being and patient safety. Addressing these challenges is critical to improving outcomes for both staff and patients. This study aimed to explore nurses' perspectives on night shift work, identify fatigue countermeasures, and elicit nurses' recommendations for improving working conditions. This mixed-methods study was conducted in two phases. In Phase One, night shift nurses at 12 hospitals within a northeastern U.S. health care system were surveyed to assess their night shift experiences. Phase Two employed focus groups at six of those hospitals to gain insight into night shift nurses' perspectives on the challenges they face and suggestions for improvement. Descriptive statistics were used to analyze the survey data. Thematic analysis of focus group transcripts was conducted to identify themes. The survey results identified gaps in night shift support, including limited access to in-person education and hot, nourishing food. Recognition of night shift nurses' unique needs was the overarching theme from the focus groups. Seven additional themes further described those needs and indicated areas for improvement: safety at night--from feeling safe to being terrified; drowsy driving; need for a break; "we're tired"--napping; nourishment at night; self-care; and night work is undervalued. The results support findings from prior research and underscore the persistent challenges night shift nurses face. While these challenges are well documented, changes to address them have been limited. Health care organizations must move beyond acknowledging the issues to implementing evidence-based interventions and structured programs. Addressing the concerns of night shift nurses is imperative and necessary to safeguard nurses' health and well-being; reduce turnover; and ensure safer, high-quality patient care.

Gestational breast cancer (GBC) is defined as a breast cancer diagnosis during pregnancy or within 12 months post-partum. The incidence of GBC varies between 1:1000 and 1:3000 pregnancies. Breast cancer is the most frequent malignant tumour in women and the leading cause of cancer-related female mortality worldwide. The main objective of this study was to better understand the experiences of women diagnosed with GBC and their interactions with the healthcare system. By exploring their perspectives, the study aimed to contribute to further research and knowledge to improve care and outcomes for these women. A qualitative exploratory study. The study involved one-on-one semi-structured interviews conducted in Australia between November 2021 and June 2022. Participants were women diagnosed with GBC. Interviews were recorded digitally, transcribed verbatim, and analysed thematically following Braun and Clarke's (2006) six steps. Six women diagnosed with GBC participated in the study. Analysis determined three central themes. First: My happiness was stolen. Upon receiving a GBC diagnosis, women described feeling terrified, overwhelmed, concerned for their baby, distressed, yet feeling fortunate at the same time. Second: It really knocked me around. Women expressed their unique circumstances and difficulties in comprehending having a cancer diagnosis while being pregnant, the different treatment modalities, limited information on surgical and fertility preservation options, and being unprepared for the side effects. Third: I wanted control; the importance of being able to take charge of their circumstances and decision-making was important to these women, especially as options were frequently restricted due to the urgency to commence treatment. The findings provide an understanding of the unique challenges of women diagnosed with GBC. Empowering women through personalised knowledge about their disease, understanding their needs, discussing surgical options, addressing fertility preservation, and providing psychological support is essential. This study interviewed six women to learn about their experiences of being diagnosed with gestational breast cancer (GBC) and their interactions with the healthcare system.Why Was the Study Done? There is limited information available about the experiences of women with GBC. As more women are delaying pregnancy until later in life, those aged 35 years and older are at a higher risk of developing GBC. The study provided a platform for deep, reflective conversations with women who had experienced GBC in Australia, allowing researchers to identify potential improvements in clinical practice and patient care, ultimately supporting these women within the community and healthcare system.What Did the Researchers Do? A qualitative exploratory design was used to explore the experiences, perceptions, and insights of women diagnosed with GBC. The researchers collected qualitative data using semi-structured interviews with six women who had experienced GBC. The interviews were transcribed verbatim and analysed using thematic analysis based on Braun and Clarkes’ (2006) six steps. Thematic analysis is a qualitative research method well-suited for explorative qualitative research, where the goal is to uncover and interpret patterns or themes within the interview transcripts.What Did the Researchers Find? The study identified three main themes and six subthemes that highlight the specific challenges women face due to their age, timing of diagnosis, life stage, and emotional responses to their diagnosis. Participants reported difficulties in understanding their diagnosis, a lack of information, managing treatment side effects, and the complexities of returning home to care for their children.What Do the Findings Mean? The findings highlight the need for healthcare services to recognise the importance of psychological care for women with pregnancy and breast cancer. Healthcare organisations can implement effective communication strategies for each treatment modality plan ensuring women have the information needed to make informed decisions about their health and that of their unborn or newborn child.

This study aimed to describe women's experiences of perineal wound dehiscence of a second-degree perineal tear and choice of resuturing or conservative treatment in the first two months after birth. A qualitative descriptive study using individual semistructured interviews was conducted. Data were analysed using Braun and Clarke's reflexive thematic analysis approach to explore women's experiences and perspectives on dehisced perineal wounds of a second-degree perineal tear. Interviews were audio-recorded, transcribed verbatim and analysed concurrently with data collection. Perineal clinics at the Department of Obstetrics and Gynaecology at two large University Hospitals in Copenhagen, Denmark. 17 women with dehisced perineal wound of a second-degree perineal tear. Three main themes were identified: (1) The unforeseen troubles: for the women with perineal wound dehiscence, the pain intensified immensely after the birth. It was an unexpected complication, and it affected the women negatively in various ways. (2) The emotional turmoil: it was a crisis for the women that their lower bodies were not intact. They were terrified, and they wondered if they had themselves to blame. Most women emphasised that choosing between resuturing or conservative treatment was a difficult and lonely decision. (3) Living with changes: regardless of treatment approach, women in both groups reported gradually managing their complicated healing and pain, but were concerned about their genitals and future births. The findings indicate that wound dehiscence was related to a painful postpartum period and an altered body image, and that the women generally found choosing between resuturing or conservative treatment difficult.

Ireland has the highest COPD hospitalisation rate in the OECD (315 per 100,000 vs. an average of 190), yet possesses the infrastructure and reform ambition-through Sl&#xe1;intecare-to deliver care differently. Virtual Care Pathways underpinned by Remote Patient Monitoring offer one route out of this costly, hospital-centric cycle, but the question is not simply whether they work. It is how, for whom, and at what cost to equity. We conducted a 20-month prospective mixed-methods feasibility study at Galway University Hospital, enrolling 85 adults with high-risk COPD (GOLD Group B/E) into a nurse-led, protocol-driven Virtual Care Pathway using tablet-based remote monitoring with 5G connectivity. Clinical outcomes were evaluated against historical baselines; patient experience was explored through focus groups and serial surveys, with findings interpreted through a critical realist lens and the NASSS framework. Of 152 exacerbation episodes managed on the platform, 148 (97.3%) were completed without hospital admission. Mean length of stay was 5.15 days-a 51.5% reduction against the regional baseline of 11.8 days (p < 0.001)-translating to an estimated &#x20ac;949,000 in gross hospital cost avoidance. Borg dyspnoea and CAT scores improved significantly beyond minimal clinically important differences. But the qualitative data complicates this picture. Patients embraced the platform largely because hospital terrified them, not because the technology delighted them. The "digital safety net" generated its own anxieties around device failure and clinical abandonment, and families-particularly daughters and grandchildren-absorbed a hidden burden of technical troubleshooting that the model depends on but does not account for. Most critically, every participant owned a smartphone. In a country where 37% of over-65s are digitally excluded, and where COPD prevalence is itself socially patterned, the absence of digitally excluded patients from our sample is not a limitation to footnote-it is the finding. Without deliberate design of hybrid digital-analogue pathways, Ireland risks cementing an "Inverse Digital Care Law" in which the most effective care reaches those who need it least.

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The diagnosis of a childhood brain tumor impacts the psychological well-being of parents who experience high levels of post-traumatic stress. To understand the etiology of trauma through this unique healthcare experience, a journey mapping exercise was undertaken with parents of children with brain tumor. Data were collected in an online focus group and by written responses. Framework analysis and research poetry were used to map experiences of traumatization and trauma-informed care across time. Nine mothers mapped their experience of their child's brain tumor care describing their needs and responses. Findings are presented by eight milestones, supported by research poetry composed of participant quotes titled: "I must be wrong," "All the fear, no answers," "Paper Thin," "Happy but Terrified," "The Rest of Him," "Less Than," and "Into Our Destiny." Throughout the trajectory of care, parents reported traumatic events and moments of helplessness attributed to the healthcare received, contributing to unrelieved distress. Increased transparency in communication between clinicians and parents fostered increased trust and psychological safety within healthcare services. Understanding the traumatization that occurs across the trajectory of care can inform service improvements and early linkage to specialized support. This study contributes novel understanding of traumatization for parents of children with brain tumor and depth in understanding of emotional components through the presentation of research poetry.

Adolescent girls living in low-income urban informal settlements face unique challenges that elevate their susceptibility to early childbearing. However, there has been limited research attention, especially qualitative studies, on their use or non-use of antenatal care (ANC) services. Informed by the socioecological theory, we examined the obstacles to and facilitators of ANC services use among pregnant adolescent girls in a low-income urban informal settlement in Kenya. The study adopted a qualitative explanatory design. We purposively selected 22 adolescent girls aged 13-19 who were either pregnant or had given birth, 10 parents and three health providers to participate in individual interviews. We employed inductive and deductive thematic analyses informed by socioecological theory to explain the barriers to enablers of antenatal services use among pregnant adolescent girls in low-income informal settlements. Most adolescent girls interviewed faced barriers at multiple socioecological levels, resulting in delayed ANC initiation and fragmented engagement with services. At the intrapersonal level, girls grappled with internalised stigma and late pregnancy recognition and acceptance, often dismissing early signs due to fear or denial. Their young age and limited knowledge of maternal health left them terrified in fear, caught between societal judgement and the daunting prospect of confronting their condition. At the interpersonal level, societal stigma and discrimination pushed many into secrecy, hindering their access to antenatal services. However, parents, other family members, and health providers played a key role in enabling access to care by offering various forms of support to pregnant girls, including offering counselling and accompanying girls to clinics. At the organisational level, user fees and condescending health providers' attitudes hindered ANC use. Yet, good patient-provider communication, privacy and confidentiality played a key role in enabling ANC attendance. Pregnant adolescent girls face unique challenges that prevent them from accessing ANC early and completing the recommended number of visits. These challenges range from intrapersonal factors to interpersonal and organisational factors. Programmes to improve early initiation of ANC for pregnant adolescents should include interventions that address the social stigma associated with early and unintended pregnancy, promote family support and make health facilities responsive to the needs of pregnant girls.

Six themes have been identified reflecting the perspectives and experiences of adults with AKI. Patients are unaware of AKI diagnosis and prognosis, feel that care is fragmented, and are burdened by treatment. Providing education, reducing treatment burden, and ensuring excellence in care may help to address patients' needs and improve AKI management. AKI is associated with higher risk of mortality and progression to CKD. The challenges and uncertainty in the diagnosis, self-management, and prevention of AKI can be distressing for patients. We aimed to perform a systematic review of qualitative studies/surveys that reported the perspectives and experiences of adults with AKI. We searched MEDLINE, Embase, PsycINFO, and CINAHL from inception to January 17, 2024. Thematic textual analysis was used to synthesize the findings. We included 20 studies (ten qualitative studies, ten surveys) involving 867 participants. We identified six themes: navigating the unknown (an unexpected and unfamiliar diagnosis, tossed about in a fragmented system, and dismissed and vulnerable at discharge); impaired life participation, relationships, and well-being (limiting ability to do daily activities and straining relationships); unbearable and unsustainable treatment burden (adding strain on family members, financial pressure because of medical expenses, and cumulative stress of ongoing monitoring); uncertain whether recovery is attainable (possible permanence of kidney damage, fear about nephrotoxic medications, and terrified about the need for dialysis); less consequential than other health priorities (short term and reversible and prioritizing other comorbidities and conditions); and empowered in managing own health (focusing on optimizing kidney health, gaining confidence in self-management, and reassured with social and clinical support). Patients may be unaware of their AKI diagnosis and prognosis, feel that care is fragmented, and be burdened by treatment. Providing education, alleviating treatment burden, and implementing a comprehensive model of care may help to address the needs of patients with AKI leading to better outcomes.

This study aimed to examine the experiences and emotions of individuals who experienced the Kahramanmara&#x15f; earthquake. This study's data, which were collected using qualitative research methods, were collected through face-to-face individual interviews between March 20 and March 21, 2023, after the earthquake in Hatay and Diyarbak&#x131;r. The purposive sample method, one of the purposeful random sampling methods, was used in the research. A total of 35 individuals formed the study's sample. Colaizzi's phenomenological interpretation method was used in the analysis of the data. The data obtained from the individual interviews with the participants were gathered under three main themes: earthquake moment, emotions, and after the earthquake. In the study, it was determined that the participants stated that they were terrified by the noise and shaking at the time of the earthquake; they could not go out immediately, it was cold when they went out, and they witnessed that everywhere was dark and destroyed. It was determined that the emotions experienced by the participants were anger, helplessness, guilt, hope, and hopelessness, and they expressed their needs after the earthquake, the difficulties in getting help, and the losses they experienced. Remarkably, the study results are often parallel to acute stress, loss, and grief reactions, and the needs of individuals are the basic principles of psychological first aid. &#xa0; Cite this article as: G&#xfc;m&#xfc;&#x15f;, F., & Dike., G. (2025). "Our lives have gone" experiences in and after Kahramanmara&#x15f;&#xc4;T&#xfc;rkiye earthquake: A qualitative research. Florence Nightingale Journal of Nursing, 33, 0112, doi:10.5152/FNJN.2025.24112.

Circadian rhythms have evolved in almost all organisms to adapt day-night cycle and control a broad range of bodily functions including appetite, activity and response to environmental disturbances. Here, for the first time, we performed terrified-sound stress model in female rats during different time of a day (in daytime or nighttime) for 21&#xa0;days to explore the effects of circadian rhythms on psychological stress (PS)-induced cognitive impairment outcome. Our results showed that PS in daytime (PS-D) led to a worse impaired short-term memory but not spatial learning memory. As for PS during nighttime (PS-N), a more severe impairment in spatial learning performance was discovered accompanying with a less impaired short-term memory performance. Further GO enrichment and KEGG analysis of DEGs found items including axon guidance, negative regulation of neuron apoptotic process, memory and synapse organization and cell projection, and pathways including axon guidance, GABAergic synapse, calcium signaling pathway, cAMP signaling pathway, cGMP-PKG signaling pathway and circadian entrainment, indicating that the mechanisms were related to neurons and synapse. Golgi staining discovered that a decreased number of interactions and dendritic spines only in PS-N, which was consistent with the lower expression of PSD95 in hippocampus. What's more, BDNF was significantly decreased in both stressed groups, while SYN had no change. All these results demonstrated that circadian rhythms have a great influence on cognitive performance and hippocampal neuron after being stressed, and it seems that PS in nighttime will come with more severe cognitive impairment.

This cross-sectional study highlights the concerning relationship between stimulants, alcohol use, and weight-related problems among Palestinian refugee men in the West Bank. Self-administered questionnaires were used to gather data on stimulants and alcohol use and eating attitudes and behaviors (EAT-26). The findings revealed that many refugee men were daily cigarette (61.4%) and waterpipe smokers (15.5%), while 30.6% and 2.3% were daily energy drink and alcohol users, respectively. Moreover, most refugee men (67.3%) were obese, and 23.5% were terrified about being obese. They had disordered eating habits, including the impulse to vomit after meals (63.3%). Moreover, 30.7% scored &#x2265;20 using EAT-26 scale, and 44.4% scored at least one positive behavior, including binge eating (40.4%), purging (10.0%), using laxatives or diet pills (8.3%), excessive exercise (30.9%), and losing weight (24.6%). The results of the adjusted binary logistic regression indicated that risk factors associated with self-induced vomiting were daily (OR = 2.71, p-value = 0.004) and weekly energy drink intake (OR = 2.41, p-value = 0.023), weekly alcohol intake (OR = 10.83, p-value = 0.036), and obesity (OR = 2.57, p-value = 0.002), while inversely associated with weekly waterpipe smoking (OR = 0.297, p-value = 0.007). Obesity was inversely associated with daily (OR = 0.146, p-value < 0.01) and weekly waterpipe smoking (OR = 0.259, p-value = 0.002), and weekly cigarette smoking (OR = 0.251, p-value < 0.01). The study underscores the urgent need for community awareness, professional evaluation, and treatment for obesity and disordered eating habits among Palestinian refugee men. It is essential to address the detrimental effects of alcohol and energy drink intake and tobacco smoking to improve the health outcomes of this vulnerable population.

Interventions targeting core characteristics of eating disorders (EDs) can effectively alleviate symptoms. However, it remains unclear whether these characteristics exhibit cultural specificity within the Chinese population. This study combines exploratory graph analysis (EGA) and network analysis to identify key psychological characteristics in Chinese patients with EDs. The psychological characteristics of 1,001 patients with EDs were assessed using the Eating Disorder Inventory-1 (EDI-1). Nineteen representative items were selected and categorized into different dimensions through EGA. Network analysis was then performed to identify key psychological characteristics by determining central and bridge nodes. In addition to the "ED-specific" and "Non-specific" categories, an unexpected category, "Perfectionism," was identified. Across these three categories, four key psychological characteristics were highlighted: "terrified of gaining weight," "guilty after overeating," "worry that feelings will get out of control," and "must do things perfectly." Beyond drive for thinness, perfectionism and emotional regulation difficulties may represent key psychological characteristics among Chinese individuals with EDs. These findings could help inform the development of culturally tailored treatment strategies for EDs in China. This study looked at the main psychological traits of eating disorders (EDs) in people from China to understand how treatments could better fit their needs. The researchers found that people with EDs often struggle with a strong fear of gaining weight, feeling guilty after eating too much, trouble managing emotions, and putting too much pressure on themselves to be perfect.These traits were grouped into three categories: those directly related to eating disorders, general mental health issues, and perfectionism. Perfectionism and difficulties controlling emotions were found to be just as important as concerns about weight.This means that treating eating disorders isn&#x2019;t just about food and weight&#x2014;it&#x2019;s also about addressing perfectionism and emotional struggles. These findings could help create more supportive and effective treatments for people in China, helping them feel more in control and less overwhelmed in their daily lives.

Violence at work against healthcare professionals is a frequent and pervasive problem. There are growing data that indicate nurses are especially susceptible to experiencing violent acts at work. Resilience helps strengthen nursing competency in the proper management of stressful circumstances, like being exposed to workplace violence. The aim of the study is to assess the impact of resilience on workplace violence among mental health nurses. A cross-sectional research design was used to conduct this study with a convenience sample of 361 nurses recruited from a governmental psychiatric hospital in Saudi Arabia. Tools. Data were collected using two tools: the first tool was the workplace violence questionnaire, which collected nurses' demographic, job, and workplace violence data, and the second was the resilience at work scale to assess nurses' resilience. This survey found that 70.4% of nurses experienced workplace violence in the last year, and fewer than half were resilient at work. Close to one-third (33.5%) of nurses were terrified and confused after workplace violence. The most violent repercussions were psychological (46.8%): dread, tension, and worry. Additionally, 48.8% of nurses exhibited high work resilience. A considerable percentage of mental health nurses encountered instances of violence during the provision of care inside mental health hospital settings. The variables of nationality (non-Saudi nurses), rotating work shift, educational levels, and exhibiting a lower level of resilience were found to have a statistically significant correlation with instances of workplace violence. Recommendation. Training programs and educational initiatives should be developed and implemented to equip nurses with the necessary knowledge and skills to effectively respond to and prevent workplace violence incidents. By providing comprehensive training, healthcare organizations can empower nurses to address and mitigate workplace violence, ultimately creating a safer and more supportive work environment.

Male infertility has emerged as a global issue, partly attributed to psychological stress. However, the cellular and molecular mechanisms underlying the adverse effects of psychological stress on male reproductive function remain elusive. We created a psychologically stressed model using terrified-sound and profiled the testes from stressed and control rats using single-cell RNA sequencing. Comparative and comprehensive transcriptome analyses of 11,744 testicular cells depicted the cellular landscape of spermatogenesis and revealed significant molecular alterations of spermatogenesis suffering from psychological stress. At the cellular level, stressed rats exhibited delayed spermatogenesis at the spermatogonia and pachytene phases, resulting in reduced sperm production. Additionally, psychological stress rewired cellular interactions among germ cells, negatively impacting reproductive development. Molecularly, we observed the down-regulation of anti-oxidation-related genes and up-regulation of genes promoting reactive oxygen species (ROS) generation in the stress group. These alterations led to elevated ROS levels in testes, affecting the expression of key regulators such as ATF2 and STAR, which caused reproductive damage through apoptosis or inhibition of testosterone synthesis. Overall, our study aimed to uncover the cellular and molecular mechanisms by which psychological stress disrupts spermatogenesis, offering insights into the mechanisms of psychological stress-induced male infertility in other species and promises in potential therapeutic targets.

This study aims to examine patients' preoperative COVID-19 fear levels, hygiene behaviours, postoperative personal protective clinical measures, and their correlations with each other. This research is a cross-sectional type of study. The study sample consisted of 131 patients hospitalized in the general surgery inpatient ward of a hospital in Turkey. The sample was determined by G-Power analysis. The data were collected in two stages in a research hospital between 1 April 2021 and 1 March 2022. Sociodemographic and Clinical Information Form, COVID-19 Fear Scale, COVID-19 Hygiene Scale were used before surgery; COVID-19 personal protective clinical measures questionnaire was used after surgery. Descriptive statistics, independent t-test, ANOVA test, Wilcoxon test and Spearman correlation analysis were used to evaluate the data. It was determined that preoperative COVID-19 fear levels, hygiene behaviours, and the personal protective clinical measures developed after the surgery were above moderate. A statistically significant and positive correlation was found between the COVID-19 Fear Scale and the preoperative COVID-19 Hygiene Scale and postoperative COVID-19 personal protective clinical prevention questionnaire total score and sub-dimension score averages. Patients' COVID-19 fears, preoperative and postoperative hygiene behaviours are statistically significantly associated with each other at a low level; postoperative clinical precautions and preoperative hygiene behaviours are statistically significantly associated with each other at a high level. The results of this study show that patients are terrified of COVID-19 while they are hospitalized due to surgical intervention during the pandemic process, and they increase their hygiene measures. It is thought that the results of the study will guide the regulation of clinical measures, patient education, and nursing care to be developed for patients during pandemic periods. No patient or public contribution.