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This philosophical analysis combines Watson's theory of human caring with Levinas's relational ethics to examine the nurse-patient relationship as a moral encounter that creates nursing knowledge. Watson's theory alone cannot explain the ontological priority of moral responsibility in nursing identity; Levinas provides this foundation, while Watson demonstrates how moral obligation manifests therapeutically. Through a structured three-stage inquiry, nine core concepts are analyzed to resolve tensions between ethical asymmetry and mutual transformation. The synthesis shows that ethical responsiveness to vulnerability drives transpersonal caring processes, positioning the nurse-patient relationship as central to professional identity rather than just a part of the practice context. This integrated framework highlights relational ontology as fundamental to nursing science, with implications for practice change, curriculum design, and research focused on transpersonal caring.

This column presents a scholarly dialogue with Dr. Lorraine O. Walker. As a co-author of the book Strategies for Theory Construction in Nursing (Walker & Avant, 2019), first published in 1983 and now in its 6th edition, Dr. Walker has made substantial contributions to advancing nursing knowledge and nursing practice. Furthermore, she has dedicated herself to the scientific inquiries into the motherhood transition with its implications for maternal and infant health. In this scholarly dialogue, she shares her expectations of concept analysis for the nursing discipline, along with her new research endeavors and the future of nursing as a science and discipline. It will guide nurse scholars to the world of nursing as a science.

This column presents a scholarly dialogue with Dr. Sandra Schmidt Bunkers, a senior Parse scholar, who sheds light on the humanbecoming paradigm-guided nursing sciencing, living the art, teaching-learning, and nursing policy development. Exploring Dr. Bunkers' scholarly works, with her wisdom and experiences shared in the scholarly dialogue, provides valuable guidance for the future of nursing, creating a new horizon of nursing as a unique discipline and practice.

This is an introduction to the review of An Educator's Guide to Humanizing Nursing Education Grounded in Caring Science by Cara et al. (2021). It allows readers to gain a new understanding of nursing education informed by theoretical perspectives that position nursing as a human science.

This concept analysis clarifies the meaning of patrescence in nursing, the developmental transition through which a male nurse becomes a father. Using Walker and Avant's eight-step method, we identified defining attributes including: identity integration, relational reorientation, moral recalibration, temporal development, and work-life negotiation. We also explore antecedents, consequences, and empirical referents. Patrescence is presented as a moral and relational transformation linking personal fatherhood with professional caregiving identity. Understanding this process informs nursing theory, education, and organizational policy supporting nurse-fathers' well-being and role integration.

The purpose of this article is to examine how nursing paradigms and the theories and research that arise from them contribute to the creation of unique nursing knowledge that fortifies the discipline.

The management of anger is problematic for many people and it is a particularly important issue for persons with substance use disorders (SUD). The paper reviews the research studies dating back to 2005 on how to help persons with SUD manage anger. The literature reveals that various pharmaceutical and non-pharmacological approaches have been studied to help persons with SUD manage their anger. In chronic and lower risk situations non-pharmacological are the first line approaches, they include anger management training, cognitive-behavioral based treatments, exercising and relaxing, music therapy and empathy. Atypical antipsychotic and medications for opioid use disorders (MOUD) are also widely used. In acute and high risk of violence situations physical restraint and pharmacological management are the first line intervention. Various nursing frameworks provide a useful basis for integrating various approaches. Current approaches have their advantages and disadvantages and are discussed in this paper.

Einstein's statement that imagination is more important than knowledge is explored in considering the importance of imagination in the teaching-learning of nursing. Insights from others on the possible meaning of Einstein's statement provide a basis for considering opportunities for imagination to flourish in teaching-learning while building on a solid foundation of what is known. Using the humanbecoming teaching-learning model, ideas are offered for faculty consideration.

The use of artificial intelligence (AI) technology is rapidly expanding in nursing and society. However, its use in healthcare comes with a number of challenges and concerns. The authors of this article use the sociotechnical model to consider the expanding use of AI in nursing and healthcare from a global perspective. Select references from the literature are used to support this important discussion for nurses and other healthcare professionals. Artificial intelligence is a major innovation that, if used properly, can reduce errors and improve efficiency and healthcare quality. It has also been shown to increase patient support, healthcare access and patient care. Here the authors address some of the limitations and challenges of using AI in nursing globally.

The author of this article presents an introduction to the review of Transcultural Concepts in Nursing Care by Boyle and colleagues (2025), a valuable resource for integrating cultural caring into nursing. The text draws on Leininger's theory of culture and care diversity and universality to provide a comprehensive, holistic view of culture care.

With the publication of this volume and issue, Nursing Science Quarterly (NSQ) will "just keep moving on," carving out its place for the enhancement of the nursing discipline, while seeking innovative ways to expand knowledge development in the health sciences.

Shared decision making (SDM) is an approach in which patients and healthcare providers simultaneously work to make decisions about tests, treatments, or chronic conditions management. To explore any possible interventions between cancer patients, nurses in the SDM process need to be up to data on the current literature. A global focused literature review of English and Italian language papers on the topic was done. The search included the use of the following terms: shared decision making, cancer patient, and nurse. Fourteen studies that were the best fit with the inclusion criteria were included to create this narrative review. The conclusion was that cancer nurses seemed to be relevant in cancer teams to support patients in their SDM processes. They do this by balancing the evidence on options, preferences, and values through a decision coaching approach to determine the best practices for supporting patients in their decisions.

Truth is a phenomenon that can get glossed over, yet truth captures fundamental values and beliefs about approaches to nursing science and nursing practice. This article views the philosophical basis and practices that arise from different schools of thought that influence the uniqueness of nursing disciplinary practices.

This paper explored imagination with leading-following processes. These processes were discussed in light of the humanbecoming paradigm's leading-following model. In the spirit of "creative conceptualizations," the humanbecoming paradigm, this author explored the ways in which imagination shapes the ways nursing and healthcare leaders' ideas and projects may move along in distinctive ways. Leaders guided by a nursing theoretical framework have a firm "place" to move projects and ideas forward that align with shared missions and visions. The utilization of imagination with a nursing framework moves the boundaries of ideas and projects to something new, marking unique cocreated contributions.

This paper presents the theory of asthma self-management, a middle-range theory that focuses on the personal, socioeconomic, environmental, and healthcare-related factors that affect asthma self-management behaviors and asthma control in adults. The theory of asthma self-management was deduced from Orem's self-care theory, one of the three subtheories of the self-care deficit theory of nursing. A substruction model is included and illustrates the linkages between the concepts of Orem's self-care theory and the novel middle-range theory. The development of this theory expands the body of nursing science by bridging an existing theory with current asthma knowledge.

The scholar aims to enhance the nursing knowledge base on trust through an integrative, cross-disciplinary literature review. The phenomenon of trust has been examined across several disciplines but has not yet been integrated for a comprehensive understanding. The scholar synthesizes literature from nursing, business, psychology, philosophy, law, medicine, and social work. Three themes emerge: (a) trust prompts authentic relationships; (b) trust fosters confidence; and (c) trust engenders vulnerability.

During early months of the COVID-19 pandemic, presentations for acute myocardial infarction (AMI) declined significantly, and outcomes worsened. However, the full extent and long-term sequelae of changes in AMI epidemiology during the pandemic remain uncertain, as does whether these patterns differed by rurality. To describe the epidemiology of AMI-related hospitalizations, interventions, and outcomes among Medicare beneficiaries throughout the COVID-19 pandemic, focusing on differences in urban and rural populations. This retrospective cohort study included all Medicare fee-for-service beneficiaries with AMI between January 1, 2018, and December 31, 2023, in the analysis. Data were analyzed from March 19 to July 9, 2025. Time period (prepandemic [January 1, 2018, to December 31, 2019], pandemic [January 1, 2020, to December 31, 2021], and postpandemic [January 1, 2022, to December 31, 2023]) and beneficiary-level rurality. The primary outcome was in-hospital death, defined as death within 1 day of discharge from the index episode of AMI. Secondary outcomes included death within 90 days of the index admission date and postdischarge outcomes. AMI episodes were defined as any emergency department (ED), observational, or inpatient stay with a primary ST-segment elevation myocardial infarction (STEMI) or non-STEMI (NSTEMI) diagnosis or a primary cardiogenic shock and secondary STEMI or NSTEMI diagnosis. Generalized estimating equations clustering on hospitals were used to compare pandemic and postpandemic outcomes with the prepandemic period, adjusting for beneficiary characteristics. A total of 1 152 851 AMI episodes among 1 032 212 beneficiaries were identified between 2018 and 2023, of which 75.6% were NSTEMI. Most AMI episodes were among male (57.6%) beneficiaries aged 65 to 80 years (56.8%). The unadjusted quarterly incidence of AMI decreased from 17.2 to 13.0 episodes per million beneficiary days at risk (quarter 1 of 2018 to quarter 4 of 2023). In-hospital (adjusted odds ratio [AOR], 1.09; 95% CI, 1.07-1.11]) and 90-day mortality (AOR, 1.10; 95% CI, 1.09-1.12) increased during the pandemic and then returned to baseline or lower (AORs, 0.99 [95% CI, 0.97-1.01] and 0.96 [95% CI, 0.95-0.98], respectively). After the pandemic, beneficiaries were less likely to discharge to a skilled nursing facility (AOR, 0.67; 95% CI, 0.66-0.68), utilize the ED (adjusted incidence rate ratio [AIRR], 0.93; 95% CI, 0.92-0.94), or experience readmission (AIRR, 0.90; 95% CI, 0.90-0.92) within 90 days of their index episode of AMI. Patterns were largely similar by rurality. In this retrospective cohort study of fee-for-service Medicare beneficiaries, the incidence of AMI decreased during and after the pandemic. Beneficiaries experienced greater in-hospital and 90-day mortality during the pandemic. After the pandemic, in-hospital and 90-day mortality returned to baseline among micropolitan and rural beneficiaries and was lower than baseline among urban beneficiaries.

The Neuman systems model is a holistic framework consisting of stressors and related reactions that has been applied to family caregivers of people with chronic diseases. Given the lack of recent critique, this study systematically analyzes and evaluates the model according to Fawcett and DeSanto-Madeya's 2013 framework, including examination of its testability and empirical adequacy for family caregivers of people with chronic diseases. Although the model has limited internal consistency and lacks parsimony, it has clear concepts and propositions that reflect the nursing metaparadigm, and it has demonstrated its social and theoretical significance, testability, and empirical and pragmatic adequacy.

Benchmarking is an effective strategy to improve antibiotic use but remains underutilized in long-term care(LTC). In 2018, the Massachusetts Department of Public Health, in partnership with Tufts Medical Center, launched the Antibiotic Start(AS) Reporting Program, a statewide initiative to monitor and improve antibiotic prescribing in LTC facilities through monthly reporting and feedback, alongside other stewardship interventions. LTC facilities voluntarily submitted monthly AS data through an online platform. AS rates were calculated as AS per 1,000 resident-days. Quarterly benchmarking reports and educational activities(introduced in 2022), including LTC office hours webinars, were conducted to support interpretation and engagement. We conducted an interrupted time series(ITS) analysis to assess changes in beta-lactam and fluoroquinolone prescribing from 2018 to 2024, and a stratified analysis comparing AS rates between facilities with and without honor roll recognition. A total of 217 LTC facilities submitted &#x2265;1 month of AS data. The overall AS rate rose 7%, from 7.22 to 7.70 per 1,000 resident-days. Fluoroquinolone starts decreased 36%, while beta-lactam starts increased 26%. ITS analysis showed a significant rise in beta-lactam use following the October 2022 expansion of benchmarking reports and LTC office hours(p<0.001). A subgroup analysis showed higher total and beta-lactam AS rates among honor roll facilities compared with non-recognized facilities. The Massachusetts AS Reporting Program demonstrates that sustained, data-driven public health-academic collaboration can advance antimicrobial stewardship in LTC. By combining benchmarking, feedback, education, and recognition, public health agencies can support stewardship engagement and promote sustainable improvement in antibiotic use across resource-limited settings.