Nurse shortages are a global issue. Adequate nurse staffing is considered crucial for the quality and safety of care. To efficiently address demands for care, healthcare organisations often employ temporary nursing staff to maintain adequate staffing levels. However, evidence concerning the association between the use of temporary staffing and patient and nurse outcomes is mixed. Work environment, patient needs, nurses' characteristics, and their perspectives on best care practices influence the match between care demand and supply, ultimately leading to different outcomes. As part of a multi-phase realist review, we aimed to test an initial programme theory on nurse staffing models that frequently use temporary nurses unfamiliar with the unit to determine through which mechanisms these models produce patient, staff, and health system outcomes in particular contexts. We systematically searched for empirical evidence on nurse staffing models that frequently used temporary nurses. After extracting context-mechanism-outcome configurations from the empirical evidence, we categorised data as supporting, explaining, or refuting our initial theory and synthesized findings to generate a refined and rival programme theory. To augment and refine our programme theory, we conducted a realist focus group and an interview with purposively selected managers and directors from care organisations and agencies, as well as a temporary nurse. We included 49 studies in our analysis that met thresholds of relevance, richness, and rigour. Findings partially supported the initial programme theory, which proposed that heavy reliance on temporary nurses unfamiliar with their assigned units could threaten care continuity, overburden permanent staff, and lead to adverse outcomes. However, this held particularly when staffing levels were low at baseline. A rival programme theory emerged, showing the advantages of using temporary nurses if there is a supportive work environment. Both theories underscore the importance of situated, often tacit knowledge, held by permanent nurses that influences staffing success. With temporary nurses a continuing staffing presence, we have highlighted the need for more research on nurse staffing models that integrate both permanent and temporary nurses. Because care organizations must ensure adequate nursing staff levels, they should consider focusing on strengthening collaboration by creating supportive work environments that are fuelled with situational knowledge. Key strategies may include fast onboarding and orientation for temporary nurses to familiarise them with patients and contexts. In intuitive work environments, temporary nurses may be able to utilise their experience and expertise, consequently enabling mutual learning.
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.
 The imbalance in nurse-to-patient ratio and shortage of nurses is the main drive for care provision by a nurse of the opposite gender. On the other hand, while nurses must recognise and respect the role of patients as partners, the nurse-patient relationship with the opposite gender in Namibia is limited because of the cultural and religious beliefs.  To explore and describe patients' experiences on opposite gender nurse-patient interactions at selected public health facilities in Namibia.  An exploratory descriptive qualitative design was employed to collect data from 14 purposively recruited patients who received care from nurses of opposite gender between June 2022 and September 2022. The interviews were audio-recorded, transcribed, and analysed using inductive thematic analysis. The study adhered to the Consolidated Criteria for Reporting Qualitative Research reporting guideline.  Two major themes emerged: (1) barriers to opposite-gender nurse-patient interactions, which include culturally insensitive care, gender-related privacy concerns, and age-insensitive care; and (2) strategies to improve nurse-patient interactions, describing the strategies to promote privacy and patient comfort, create a safe space for disclosure and implement gender-concordant care to address the identified barriers.  The findings of this study revealed that patients had negative experiences with opposite gender nurse-patient interactions. The study recommends the provision of privacy, creating a safe space for disclosure and providing gender-concordant care to create trust and improved satisfaction with nursing care.Contribution: The study provides essential insights into the cultural nuances of opposite gender nurse-patient interactions within the public health sector.
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 ± 9.42). Significant competency disparities were observed across all hospital tiers (p < 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 > 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 = 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 examined the associations between nurses' resilience and specific components of sleep quality and explored whether prior experiences of patient attacks influenced these relationships. Nurses work under demanding conditions that may compromise resilience and sleep health. Understanding these relationships may help inform targeted strategies to support well-being and practice. A cross-sectional correlational study was conducted among registered nurses from tertiary hospitals in Southwest China (N = 697). Resilience was assessed using the 10-item Connor-Davidson Resilience Scale (CD-RISC-10) and sleep quality using the seven Pittsburgh Sleep Quality Index (PSQI) components. A psychometric network model was estimated using EBICglasso regularization. Strength centrality, bridge centrality and network accuracy and stability were assessed using bootstrap procedures. Group differences by patient attack experience were examined using the Network Comparison Test with false-discovery-rate correction. The sleep components were closely interconnected. The strongest positive associations were observed between sleep duration and sleep efficiency and between sleep disturbances and daytime dysfunction. The strongest negative association was between sleep latency and subjective sleep quality. Sleep disturbances and subjective sleep quality were the most central nodes. Bootstrap analyses supported acceptable stability (CS = 0.52). Network structure did not differ significantly by patient attack experience. Sleep disturbances and subjective sleep quality emerged as the most central components linking resilience and multidimensional sleep quality. Interventions targeting these core domains may offer a pathway to strengthen nurses' well-being. Greater attention to resilience and sleep-focused support within hospital systems may help strengthen nurses' well-being and occupational health.
 Job satisfaction encapsulates the degree to which employees perceive fulfilment in various facets of their work, including the stability of their position, opportunities for professional development and confidence in their capability to execute tasks successfully. In Namibia, a decline in job satisfaction has been observed with nurses leaving hospitals at alarming rates, yet limited research exists on the factors influencing their job satisfaction. This study was conducted at Rundu Intermediate Hospital between June 2024 and September 2024.  The study explored factors affecting job satisfaction among nurses at Rundu Intermediate Hospital in the Kavango East Region, Namibia.  A qualitative, exploratory, descriptive and contextual design was used. Fifteen nurses from various departments were selected through non-probability convenience sampling. Data were collected via semi-structured interviews, audio-recorded, transcribed verbatim and analysed thematically.  Nurses' job satisfaction is closely linked to personal fulfilment, professional growth and contributions to patient care. Objective factors such as promotion, pay and recognition further shape satisfaction levels. Major challenges include staff shortages, resource constraints and lack of support.  Hospital management should implement strategies that reduce workload, enhance recognition and create opportunities for professional development to improve job satisfaction and retention.Contribution: The study provides context-specific insights into factors influencing nurses' job satisfaction in Namibia and proposes management interventions to strengthen morale, support professional growth and improve the quality-of-patient care.
Innovative behavior drives nursing advancement, yet the mechanism linking career calling to innovative behavior for resident nurses remains unclear. This study used bootstrap-validated structural equation modeling to examine the mediating role of career calling between job satisfaction and innovative behavior. A cross-sectional survey of 247 resident nurses at a Sichuan tertiary hospital (April-July 2024) completed the McCloskey-Mueller Satisfaction Scale, 12-item calling scale, and Nurse Innovative Behavior Scale. Structural equation modeling was used to test the direct and mediating effects with bootstrap validation. Career calling (42.83 ± 12.24), job satisfaction (119.19 ± 25.16), and innovative behavior (36.18 ± 8.48) were positively correlated (p < .01). Job satisfaction significantly predicted career calling and innovative behavior (beta = 0.263), and career calling also predicted innovative behavior (beta = 0.547). The mediation effect (0.14, 58.75%) was significant, with good model fit (comparative fit index = 0.974, root mean square error of approximation = 0.111). Career calling partially mediates the effect of job satisfaction on innovative behavior, highlighting its pivotal role in fostering innovation among nurses. Enhancing both job satisfaction and career calling may effectively strengthen the innovative capacity and professional engagement of nurses.
 Registered professional nurses are the most qualified category in the nursing profession and are mandated by the scope of practice to supervise other nursing categories during the provision of nursing care. Nursing supervision is a cornerstone of high-quality nursing care that must be integrated into daily nursing tasks to ensure patients receive optimal treatment and minimise patient complaints and lawsuits.  The objective of the study was to explore the experiences of registered professional nurses regarding supervision of nursing care in the selected hospitals of Limpopo province.  A qualitative study was conducted using an exploratory, descriptive and appreciative inquiry design. The principles of appreciative inquiry served as a guide for the data collection method. Twenty-four registered professional nurses from the maternity, paediatric and casualty departments of selected hospitals were interviewed. Data were gathered through semi-structured individual interviews using standardised interview protocols. Sample size was determined by data saturation. Though data saturation was reached at participant number 15, the researcher kept going on. In order to authenticate the findings, three participants were added from each selected hospital and clinical area.  The emerging themes included the administrative, organisational, educational and training challenges.  Nursing care supervision by registered professional nurses is essential to improve the quality of nursing care and levels of satisfaction.Contribution: This study contributes to the understanding of factors that impact of effective supervision of nursing care by professional nurses and outline the areas of improvement. The improvement in supervision of nursing care may lead to reduction of patients complaints, improved patient safety and uplift the standard of nursing care rendered.
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 Türkiye, 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.
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.
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±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% CI 0.38 to 1.26), whereas spouse participation was negatively associated (B=-8.43, 95% 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.
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 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.
This study examined the relationship between alarm fatigue and turnover intention among dialysis nurses and investigated the mediating role of professional quality of life (ProQOL). An analytical cross-sectional study was conducted. This study employed a nonprobability sample of 140 dialysis nurses from hospitals affiliated with Shahid Beheshti University of Medical Sciences in Iran in December 2024. Data for this study were collected via a multi-section survey. This research initially focused on identifying demographic and occupational variables. Section two employed the Alarm Fatigue Questionnaire; section three, the ProQOL scale; and section four, the Turnover Intention Questionnaire. Data analysis was carried out using IBM SPSS Statistics, version 27.0. The mean scores for alarm fatigue and turnover intention were 34.02 (SD = 8.50) and 48.70 (SD = 11.66), respectively. Item-level means for alarm fatigue were 2.62 (SD = 0.65) on a 0-4 scale. Also, scores were 3.30 (SD = 0.81) for secondary traumatic stress (STS), 3.61 (SD = 0.90) for compassion fatigue (CF), 3.01 (SD = 0.78) for compassion satisfaction (CS), and 3.25 (SD = 0.78) for turnover intention on 1-5 Likert-type scales. Pearson's correlation showed that alarm fatigue was positively correlated with STS, CF and turnover intention, and negatively correlated with CS. Multiple linear regression explained 62.9% of the variance in turnover intention; single marital status, CS, CF and STS were significant independent predictors. Path analysis showed a significant total association between alarm fatigue and turnover intention, a non-significant direct association, and a significant indirect association through ProQOL components, a pattern consistent with mediation by ProQOL. Path analysis showed a pattern of associations consistent with ProQOL mediating the relationship between alarm fatigue and turnover intention. The association between alarm fatigue and turnover intention appeared to operate primarily in association with STS, compassion fatigue, and compassion satisfaction, although the cross-sectional design precludes causal inference. These findings are consistent with the hypothesis that improving ProQOL may be associated with a weaker link between alarm fatigue and turnover intention, though this should be confirmed in longitudinal studies.
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.
With national nursing turnover peaking, this study was conducted to explore the orientation experiences of early career nurses. A hermeneutic phenomenological approach was used, with web-based interviews that were recorded, transcribed, and thematically analyzed. Emerging themes included seeking comprehensive information, the pivotal role of preceptors, emotional complexity, loss or absence, reaffirming purpose, and positive progress. Outliers included "the preceptor turned her back," "thrown to the wolves," and "the unicorn." Participants described orientation experiences and remained in their initial roles. However, reality and transition shock persist. Consistent support from preceptors, educators, and leaders remains essential for successful transition.
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 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 = 3.07 for IC = 4 compared with IC = 0, 95% CI 1.89-5.00) and cardiovascular rehospitalization risk (HR = 5.23 for IC = 4 compared with IC = 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.
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.