International Journal of Nursing Education
International Journal of Nursing Education is an international double blind peer reviewed, scientific journal that seeks to promote high standards of latest clinical and educative research work related to nursing education. The purpose of the journal is to bring advancement in nursing education. The journal publishes articles related to specialities of nursing education, care and practice. The journal has been assigned international standard serial numbers 0974-9349 (print) and 0974-9357 (electronic). The journal is covered by Google Scholar, EBSCOhost (USA)and Scilit among other databases This is an open access journal which means that all content is freely available without charge to the user or his/her institution. Users are allowed to read, download, copy, distribute, print, search, or link to the full texts of the articles, or use them for any other lawful purpose, without asking prior permission from the publisher or the author. This is in accordance with the BOAI definition of open access.
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The Influence of Caregiver, Social Support and Quality of Life in Elderly People with Type 2 Diabetes Mellitus in Thailand
Background: Diabetes mellitus significantly impacts the quality of life (QoL) of older adults, particularly in rural Thailand. Beyond clinical management, caregiver support and social networks are considered to be crucial determinants of well-being. However, research regarding these factors remains limited in this specific context. This study examines the influence of caregiver, perceived social support, and QoL among elderly with type 2 diabetes mellitus. Methods: A cross-sectional study was conducted among 366 elderly patients with type 2 diabetes mellitus(aged ≥60 years). Data were collected by structured questionnaires. Multiple linear regression analyses were performed to examine associations while controlling sociodemographic and health-related variables. Results: The mean age of participants was 67.70 years (SD = 4.99), with 69.67% female. Most received care from a spouse (54.37%) or family members (28.69%), while 16.94% had no caregiver. High perceived social support(β = 0.507, p < 0.001). was associated withbetter quality of life. Similarly,family caregivers(β = 0.229, p < 0.001),spousal care(β = 0.114, p < 0.05), secondary/vocational education(β = 0.367, p < 0.001)were also associated with better quality of life. Conversely, hypertension(β = -0.153, p < 0.001), depression symptoms(β = -0.139, p < 0.05) were negative associations. Conclusion: Caregiver and perceived social support were associated with better quality of life in elderly diabetic patients in rural Thailand. These findings showed the importance of psychological management in diabetes mellitusand underscore the need for holistic, community-based interventions that establish caregiving networks and social support systems to improve well-being
Copyright (c) 2026 https://creativecommons.org/licenses/by-nc/4.0
Lifestyle Intervention Program on Quality of Life and Psychological Well-being of girls with risk of developing Polycystic Ovarian Syndrome (PCOS) in selected Colleges of Bhubaneswar, Odisha
Background: Globally, Polycystic Ovary Syndrome affects 5–10% of the population of reproductive age, making it the most prevalent endocrine condition. Symptoms often include oligomenorrhea, hyperandrogenism, and obesity. Objective: The main objective of the study is to assess the effect of life lifestyle intervention program on quality of life and psychological well-being among girls at risk of developing PCOS. Method: A quasi-experimentalstudy was conducted among 120 girls at risk of developing PCOS in a selected college in Bhubaneswar (60 in the experimental group and 60 in the control group). Girls aged 16-20 years, with a PCOS risk assessment score greater than 5 and staying in the hostel, were selected purposively. Tools include 1. Socio-demographic questionnaire, 2. Risk assessment checklist to identify the risk of PCOS girls,3. Standardised SF-36 QOL questionnaire to assess the Quality of life and 4. Standardised Riff’s psychological well-being scale to assess the psychological well–being of girls with risk of developing PCOS. Result: Study result shows that there was a significant improvement in the post-test mean quality of life (QOL) score in the experimental group as compared to the control group (U=1746.0, P=0.002) and a significant reduction was seen in the posttest mean psychological well-being score in the experimental group as compared to the control group (U=1523,P=0.00). There was a significant association found between quality of life and age (c2=1.159, p=0.021), menstrual flow (c2=7.402, p=0.025), and BMI (c2=3.726, p=0.023). And significant association was found between the psychological wellbeing and type of family (χ2 = 5.574, p 0.01), menstrual flow (χ2 = 7.402, p = 0.04), and BMI (χ2 = 3.726, p = 0.02). Conclusion: The lifestyle intervention program was an effective non-pharmacological nurse-led intervention in improving the quality of life and reducing psychological well-being of girls with risk of developing PCOS.
Is The Microlearning Approach A New Way to Influence Learners’ Attitudes Towards Nursing Bioscience Education?
Objective: Historically, nursing students have found bioscience subjects challenging and anxiety provoking. To alleviate these factors, an online industry-based short course, Biochemical Basis for Human Life (BBHL) was developed. A survey with narrative analysis was used to explore learners’ experience and satisfaction with the course and evaluate the effectiveness of microlearning approach in delivering nursing bioscience education. Methods: Learners enrolled in the short course and following the course completion, they were invited to submit the End of Course Feedback survey. The survey included quantitative measures of course satisfaction, demographics pertaining to learners’ country of origin and two open ended qualitative questions. Results: A total of 444 learners were enrolled in the course, with 33.3% completion rate (148/444). Out of the learners who completed the course, 89.9% (133/148) completed the End of Course Feedback survey. Across all questions, agreement rates exceeded 90%, with negligible disagreement or nonresponse in relation to course satisfaction. Out of the learners who provided a qualitative response, majority expressed positive attitudes towards course delivery and course impact. Conclusions: This study highlighted the beneficial nature of the course and its microlearning approach in relation to nursing bioscience education. Furthermore, this study provides a new strategy for educators where a bite-sized learning can be used as pre-classroom preparation for students to enhance student engagement and decrease burden associated with extensive material coverage in the classroom.
Impact of Emotional Intelligence and Self-Efficacy on Self-Esteem Among Nursing Students
Introduction: Nursing is a profession that demands not only clinical competence but also strong emotional and psychological adaptability. Objectives of the study were to correlate the level of emotional intelligence and self-efficacy on self-esteem and to associate the level of emotional intelligence, self-efficacy, and self-esteem with their selected sociodemographic variables. Methods: Descriptive cross-sectional research design was used for the research. 289 samples were taken using the complete enumerative sampling technique. The Rosenberg Self-Esteem Scale, the General Self-Efficacy Scale, and the Schutte Self-Report Emotional Intelligence Test (SSEIT) were the tools of the study. The data gathered at the selected nursing college was analyzed by descriptive and inferential statistical methods, and interpretations were made based on the objectives of the study. Results: The study results show that a moderate positive correlation between emotional intelligence and self-esteem was observed with r = 0.64; on the other hand, a strong positive correlation of r = 0.97 was observed for self-efficacy & self-esteem. Association of the demographic variables revealed that age, course, year of the study, and religion were associated with emotional intelligence at chi-square 0.0270, 0.0038, and 0.0417, respectively, at p < 0.5 level at 95% CI. Conclusion: The study emphasizes that emotional intelligence, self-esteem, and self-efficacy are interrelated constructs influencing one another and that certain demographic factors play a significant role in shaping emotional intelligence among the participants. Promoting emotional intelligence and self-efficacy through targeted educational and psychological interventions may therefore enhance students’ overall self-esteem and personal growth.
Global Quality Assurance in Nursing Education: ACEN Standards and International Accreditation
Accreditation plays a critical role in ensuring the quality, credibility, and continuous improvement of nursing education programs worldwide. This article examines the role of accreditation in nursing education, with an emphasis on quality assurance, public trust, and the promotion of ongoing program evaluation and enhancement. Particular attention is given to the benefits of international nursing accreditation for students, faculty, institutions, employers, and communities of interest, including improved educational quality, enhanced global recognition, and increased mobility of graduates. The article also addresses challenges associated with international accreditation, such as time, financial costs, and the sustained commitment required to maintain compliance with accreditation standards. Additionally, the work highlights international accreditation efforts led by the Accreditation Commission for Education in Nursing (ACEN), outlining its global reach, comprehensive Standards and Criteria, and support for programs seeking this recognition. The article also provides an overview of the ACEN Standards and Criteria as applied in international contexts, illustrating how global quality benchmarks are implemented while respecting local regulatory and cultural frameworks.By applying consistent, globally relevant standards while allowing programs to reflect local regulatory and cultural contexts, international accreditation supports excellence in nursing education and contributes to the preparation of competent, ethical, and practice-ready nurses worldwide.
Advancing Sustainable Development Goals Through Nursing: Innovations, Impact, and the Road Ahead
Nursing is increasingly recognized as a transformative force in advancing the Sustainable Development Goals (SDGs). This article analyzes nursing’s direct and indirect contributions to the SDGs highlighting the multidimensional role of nurses in health promotion, education, gender equity, environmental stewardship, economic growth, and social justice. Nurses play a pivotal role in achieving SDG 3 through preventive care, chronic disease management, emergency response, and mental health promotion, while also significantly contributing to SDGs related to education, clean water and sanitation, decent work, reduced inequalities, climate action, and strong institutions. Bibliometric evidence underscores that nursing research is heavily concentrated on health-related goals, with notable gaps in areas such as poverty reduction and zero hunger. The article further explores nursing leadership in innovation, sustainability, ethical governance, and partnerships, emphasizing the need for stronger research integration, policy engagement, and interdisciplinary collaboration. Strengthening nursing education, leadership, and research capacity is essential to maximize its impact on the 2030 Agenda. The analysis concludes that nursing is not merely a supporting discipline in global development but a central catalyst for achieving a healthier, more equitable, and sustainable future from very ancient period.
Effect of Exposure to Asynchronous Virtual Clinical Environments on Actual/ Perceived Competence in Drug Dosage Calculation: A Pilot Study
Introduction: Nursing students are expected to be ‘practice ready’ on qualifying. This includes safe medication administration. This pilot study investigates the relationship between exposure duration to asynchronous virtual drug dosage calculation scenarios and nursing student actual and perceived competence.Methodology design planned for larger scale main study was tested and piloted. Methods: A randomised quasi-experimental research design (pre- and post-test) was used. Purposive sampling was used to recruit six groups of second/third-year pre-registration undergraduate nursing students from six sites (UK and Canada). Students were randomly assigned to four groups of different exposure to the safeMedicate® COVID-19 education module. Results: Student actual competence increased across all four groups, and their perceived competence mirrored this. There was no clear dose-response relationship demonstrated. Conclusion: Valuable insights into the effects of asynchronous virtual learning on drug dosage calculation competence among nursing students were generated. Improvement in actual and perceived competence was found, but no clear dose-response relationship. Further research on a larger scale is needed to explore the impact of instructional design, feedback, and interaction on learning outcomes.
Development of a Care Model for Substance use Patients with Mental Disorders and Aggressive Behavior in Lomkao Crown Prince Hospital
Background: Substance use in patients with mental disorders and aggression poses significant challenges to care quality and safety. However, a critical gap exists regarding integrated care models to overcome the lack of coordinated care from various departments. This study aimed to develop and evaluate a comprehensive care model for substance use patients with mental disorders and aggressive behavior. Methods: A randomized control trial (RCT) was employed, with 80 participants randomly assigned to intervention (n=40) or control (n=40) groups from May 2025 to October 2025 through structured questionnaires. The intervention group received an integrated care model and post-discharge monitoring via the LINE application. Outcomes were measured using the Overt Aggression Scale (OAS) and adherence at baseline and 4-month follow-up. A mixedeffects linear regression model was used to assess the effect of the intervention on OAS scores over time while chi-square tests were used to compare categorical variables. t-tests were used to compare continuous variables. Results:At baseline, there was no significant difference between the intervention and control groups. A significant reduction in OAS scores from baseline to 4-month follow-up (β = -35.800, p < 0.001). While the group×time interaction was statistically significant (β = 13.500, p < 0.001).Post-discharge adherence was higher in the intervention group, including LINE tracking (82.5%), medication adherence (77.5%), and appointment reminders and attendance (87.5%) (p < 0.001). Conclusion: The integrated care model significantly improved outcomes for substance use patients with mental disorders and aggressive behavior. Its success highlights the importance of interdisciplinary collaboration, staff training, and digital follow-up systems. The model offers a scalable solution for similar settings.
Nurses’ Knowledge and Practices Regarding Prevention of Cesarean Section Wound Infection: An Intervention Program
Aim: study the effect of educational program on nurses' knowledge and practices regarding prevention of caesarean section wound infection. Setting: The study was conducted in Obstetrics and Gynecology Department at Farasan General Hospital. Design: A Quasi-experimental study (pre and post-test) was utilized. Sampling: Convenient sample included 50 nurses. Tools: Two tools were used Self-administered questionnaire and Observational checklist. Results: majority of studied nurses had poor total knowledge score regarding prevention of caesarean section wound infection pre intervention. While most of them had good total knowledge score regarding prevention of caesarean section wound infection post intervention. More than majority of studied nurses had unsatisfactory total practices pre intervention toward prevention of caesarean section wound infection , meanwhile majority of them had high satisfactory total practices post intervention.. Conclusion: the intervention program had positive effect on nurses' knowledge and practices regarding prevention of caesarean section wound infection after application of program compared to before application. Recommendations: Updating knowledge and practices of nurses through continuous in-service educational programs emphasizing the importance of the evidence-based practices of prevention of caesarean section wound infection.
Copyright (c) 2026 Amira Ahmed https://creativecommons.org/licenses/by-nc/4.0
Bridging the Care Gap: A Nursing Perspective on Integrating Voice-Enabled Virtual Nurse Assistant to Enhance Patient Self-Efficacy and Mitigate Workforce Strain
Rapid digital transformation across industries has accelerated the adoption of advanced technologies to reduce manual workload, enhance efficiency, and optimize operational costs. Healthcare is undergoing a similar transformation, with artificial intelligence (AI) emerging as a key enabler of innovative care delivery models. Among these, Voice-Enabled Virtual Nursing Assistants (VNAs) represent a promising solution to address increasing care demands, workforce shortages, and rising healthcare costs. Virtual Nursing Assistants offer 24/7 availability, enabling continuous patient engagement beyond the limitations of human staffing. They assist patients by responding to health-related queries, providing medication reminders, monitoring symptoms, supporting chronic disease management, and offering emotional and mental health support. Evidence suggests that VNAs improve accuracy, timeliness, and accessibility of care compared to traditional methods. From a healthcare provider perspective, VNAs streamline documentation, support preliminary assessment and triage, enhance real-time monitoring, and optimize workflow efficiency. In critical care settings, the integration of virtual nursing roles has been identified as a viable approach to mitigating projected nursing workforce gaps while maintaining care quality. Additionally, VNAs demonstrate potential in education and staff development through virtual teaching platforms and cognitive learning enhancement. Future advancements are expected to expand VNA capabilities through wearable integration, electronic health record synchronization, advanced personalization, and diagnostic support. Despite challenges related to data security, ethics, cost, usability, and regulatory frameworks, Virtual Nursing Assistants represent a transformative digital health innovation with significant potential to improve patient outcomes, empowers especially elderly patients and reduces nurse’s workload, and strengthen healthcare systems.
Copyright (c) 2026 Komakula NKS Santhoshi, Avanthi Devi P, Veena V G, Vikas M Miskin https://creativecommons.org/licenses/by-nc/4.0
Perception regarding Objective Structured Clinical Examination and Traditional Clinical Examination among Nursing Students in North East India
Introduction: Evaluation and assessment is an important aspect for learning to assess the learner and provide feedback. This study aims to assess nursing students' perceptions regarding Objective Structured Clinical Examination (OSCE) and Traditional Clinical Examination (TCE). Methods: A cross-sectional study was conducted using a total enumerative sampling technique with 122 Nursing students from the College of Nursing in Nagaland, India. A self-structured validated questionnaire, which had two sets of self-administered questionnaires on OSCE and TCE, with 15 questions, was administered to collect data on students’ perception towards OSCE and TCE. The participants rated their responses using a 5-point Likert scale, ranging from "strongly disagree" to "strongly agree," regarding the strengths and weaknesses of the practical methods employed. The students' responses were analyzed using descriptive and inferential statistics. Results: The study revealed that out of 122 samples, 73.77% (90) had a good perception regarding OSCE, and only 26.22% (32) had an average perception. Concerning the Traditional Clinical (TCE) examination technique, 45.90% (56) had a good perception of TCE, and 54.09% (66) had an average perception. Many students found OSCE to be more organized, fair, and reliable, with minimal disturbance from patients during the examination, compared to TCE. There was a significant association between the perception of OSCE and TCE. Conclusion: Student nurses’ perception of practical and clinical assessment was found to prefer OSCE over TCE. Nurse educators can focus on using OSCE as an effective evaluation tool for students and further evaluate to improve the assessment method. However, students felt that a wide variety of clinical skills were also covered in TCE
Copyright (c) 2026 Dorjee Yanki, Imchasenla Jamir, Lolia Ozhu, Puna Sunku, Videkhono Rhetso, Bendangmenla Ao https://creativecommons.org/licenses/by-nc/4.0
Development of the Parent-Focused SWITCH Intervention to Improve Fruit and Vegetable Intake Among Elementary School Children in Myanmar: A Social Cognitive Theory–Informed Approach
Background: Fruit and vegetable (FV) intake among children in Myanmar remain below the WHO-recommended 400 g/day, with national averages around 230 g/day and substantial regional variation. Early dietary behaviours are strongly shaped by parents and the home environment, yet there is a lack of culturally adapted, parent-focused interventions in Myanmar. The SWITCH (Supporting Wellness in Children Through Home-based Change) intervention was developed to address the gap using Social Cognitive Theory (SCT). Methods: Intervention development followed the GUIDED framework to ensure transparent and systematic reporting. Evidence from the literature, national dietary reports, and baseline assessments in a Yangon school identified key determinants, including low FV knowledge, limited parental self-efficacy, reduced home availability of FV, and high sugary drink intake. These findings informed the design of an eight-week parent-focused program featuring weekly in-person sessions, home-based challenges, digital reinforcement through Viber and Facebook, and child engagement activities. Materials including recipe cards, cooking videos, FV shopping guides, and lunchbox templates were culturally adapted to the Myanmar context. Prototype materials were pre-tested with 10 parents and refined for clarity, relevance, cost practicality, and overall feasibility. Results: The finalized intervention incorporated eight weeks addressing FV knowledge, healthy cooking, meal planning, label reading, home-environment improvements, and coping strategies. Pre-testing demonstrated high acceptability: 90% found materials easy to understand, 80% found them culturally relevant, 100% considered them useful, and 90% indicated willingness to follow strategies. Cultural adaptation and digital reinforcement enhanced feasibility for urban Myanmar families. Conclusion: SWITCH is a culturally grounded, SCT-based intervention designed to improve FV intake among schoolchildren by empowering parents. Its systematic development ensures theoretical coherence, contextual relevance, and high feasibility, providing a strong foundation for evaluation in a forthcoming quasi-experimental trial.
Copyright (c) 2026 Htet Myat Aung, Chaw Hay Thar https://creativecommons.org/licenses/by-nc/4.0
Effectiveness of Fenugreek Seed Powder (Trigonella Foenum- Graceum) As Adjuvant Therapy Among Prediabetic Hospital Employees In Kerala, India.
Introduction: Prediabetes is a lifestyle disease and dietary modifications are effective for its management and prevention. Prediabetes is a greater risk factor for type 2 diabetes mellitus, cardiovascular disease, renal failure and stroke, and is one of the most critical issues regarding human health. There are economic reasons for the above statistics. As health care professional has a responsibility to innovate strategies to save the public and Lifestyle changes in dietary pattern by consuming certain traditional home remedial measures are used to maintain blood glucose in normal level. Methodology: A quantitative approach with Pre Experimental one group Pretest- Post-test design was adopted for this study. One hundred hospital employees with Prediabetes who were aged between 25-65 years were selected for the study by Convenience Sampling Technique. Data were collected and analyzed by Descriptive and Inferential statistics. Conclusion: The present study indicating that the fenugreek seed was effective on reducing the blood sugar level in Prediabetes hospital employees. The study recommends strongly to consumptions of fenugreek seed as a cost effective management of Prediabetes in all healthcare setting and community. With this regard, the researcher would like to suggest to take more number of adjuvant therapies to treat lifestyle diseases for the wellbeing of society which would turn in to better outcome.
Copyright (c) 2026 Siva Jeya Anand T, A Velmurugan, N.J Vasudevan https://creativecommons.org/licenses/by-nc/4.0
Health Literacy to Prevent Obesity in High School Students, Phatthalung Province, Thailand
Background: Childhood and adolescent overweight and obesity are global health concerns. Preventing these conditions— especially among at-risk populations—is more effective and cost-efficient than treatment. One promising approach is enhancing health literacy, which can lead to improved health outcomes. The objectives of this study were to examine the current situation and explore the associations between various factors and health literacy in relation to obesity prevention. Methods: This cross-sectional study was conducted among high school students in southern Thailand. A total of 572 students from four schools participated, using a self-administered structured questionnaire. Descriptive statistics were employed to summarize sociodemographic characteristics, lifestyle behaviors, and health literacy related to obesity prevention. Logistic regression analysis was used to examine the associations between these variables. Results: The majority of participants were female (73.3%) and most were aged 17 years (37.2%). Most students demonstrated a moderate level of health literacy regarding obesity prevention (65.4%), while 31.5% had a low level and only 3.1% achieved a high level. Significant associations were found between health literacy levels and several variables, including parental education, parental occupation, BMI-for-age, stress management behavior, sugar-sweetened beverage (SSB) consumption, alcohol use, and internet usage. Conclusion: Health literacy interventions should be adapted to students’ real-life contexts and actively involve families and communities, particularly in rural areas.
Copyright (c) 2025 https://creativecommons.org/licenses/by-nc/4.0
Personal, Social, and Institutional Factors Influencing Nursing Career Decisions: Evidence from a Post-Conflict Philippine Setting
Nursing remains a socially relevant and globally in-demand profession, yet students often struggle to make informed career decisions and maintain sustained motivation. This study explored the factors shaping nursing students’ career choices and the challenges they face at Mindanao State University – College of Health Sciences (MSU-CHS), Marawi City. Using a cross-sectional descriptive design, data were collected from 231 students through a structured questionnaire assessing personal, interpersonal, and social influences, as well as access to career, counseling. Descriptive statistics highlighted that personal motivations, particularly caring for ill family members and a strong commitment to service, were the most significant drivers of career choice. Interpersonal encouragement from family and mentors, and admiration for nurses, also shaped decisions, while social factors such as financial security and opportunities for overseas employment were influential. Students reported major challenges, including academic pressure, financial limitations, and external expectations. Most respondents indicated limited access to effective career counseling. Findings emphasize the need to strengthen institutional support by improving counseling, mental health services, and financial assistance, and by engaging parents, faculty, and community partners more effectively to prepare resilient, committed future nurses
Copyright (c) 2026 Arapia Diampuan https://creativecommons.org/licenses/by-nc/4.0
Effectiveness of “Discharge Guidance Programme” on medication compliance and complications among patients undergone heart valve replacement.
Background: In India, rheumatic heart disease (RHD) affects approximately 5 to 7 out of every 1,000 children aged between 5 and 15 years, with an estimated 1 million individuals living with the condition, with many patients needing valve replacement surgery. While surgery is crucial, effective post-operative counseling and adherence to lifelong oral anticoagulant therapy (OAT) are vital to prevent complications such as thromboembolism or bleeding. Despite the clear need, there's a notable lack of formal research in India assessing how effective counseling truly impacts patient adherence and long-term outcomes after valve replacement. Methods: A Quasi experimental research study was conducted from December 2024 to Feb 2025 , using a total enumeration method. A structured questionnaire was developed, validated, and administered to 54 patients. Results: This comparative study involving 54 heart valve replacement patients (experimental group n=27, control group n=27) at KGMU, Lucknow, assessed the effectiveness of a Discharge Guidance Programme on medication adherence and post-operative complications. Baseline demographic and clinical characteristics were comparable between groups (all p > 0.05). Kolmogorov-Smirnov test confirmed non-normal distribution of outcome variables (all p < 0.05), leading to the use of non-parametric tests. At baseline, medication adherence was similar between groups (Chi-square p = 0.362; Mann-Whitney U p = 0.517). However, the Discharge Guidance Programme significantly improved medication adherence in the experimental group. At 1st week post-discharge, 70.37% of the experimental group demonstrated high adherence compared to 18.51% in the control group (p = 0.001), with a significantly higher mean adherence score (experimental: 8.00 ± 0.00; control: 2.79 ± 1.24; p = 0.000). This improvement was sustained at 4th week post-discharge, with 88.88% high adherence in the experimental group vs. 51.85% in the control group (p = 0.006), and significantly higher mean adherence (experimental: 8.00 ± 0.00; control: 3.02 ± 1.27; p = 0.000). The program also significantly reduced post-operative complications. At 1st week post-discharge, the experimental group had a lower incidence of complications (7.40%) compared to the control group (44.4%), with a significantly lower mean complication score (experimental: 0.22 ± 0.51; control: 1.00 ± 1.24; p = 0.01). By 4th week post-discharge, no patients in the experimental group reported complications (0%) compared to 29.6% in the control group, maintaining a significantly lower mean complication score (experimental: 0.00 ± 0.00; control: 0.29 ± 0.608; p = 0.01). Significant positive correlations were found between 1st and 4th week scores for complications (r=0.377, p=0.005) and medication adherence (r=0.311, p=0.022). Conclusion: The findings of this study demonstrate that the "Discharge Guidance Programme" is an effective intervention for improving medication adherence and reducing the incidence of post-operative complications among patients who have undergone heart valve replacement. The experimental group, which received the guidance programme, exhibited significantly better medication compliance and experienced fewer complications in the crucial 4-week period following discharge compared to the control group receiving standard care. This suggests that a structured discharge guidance programme can play a vital role in enhancing patient outcomes and potentially reducing the burden of post-surgical morbidity.
Copyright (c) 2026 Vishal Dubey, Rashmi P. John, Urvashi Sharma, Sarvesh Kumar https://creativecommons.org/licenses/by-nc/4.0
OLDER Not Over: Recovery Experiences of Abandoned Elderly in Residential Care Facility
The research examines the challenges, perception, and ability to cope of abandoned elderly in the process of recovery in Residential Care Facility. This study sought to understand the new beginning and experience of abandoned elderly to achieve recovery. The researchers employed a phenomenological approach and utilize a non-probability sampling method. Following this, data is collected from 16 abandoned older adults participants using semi-structured interviews. Data saturation was achieved after interviewing the 13th informant, with additional insights gained from the first two, although redundancy occurred with the third informant. The raw data were audio recorded, transcribed, and analyzed using Colaizzi’s (1978) method. To ensure the credibility of the research, the researchers implemented member checking, comprehensive documentation of the research processes, bracketing, and an audit trails. The significant experiences of recovery have converged into a central theme, OLDER Not over, which encompasses five emerging themes (i.e., “OLDER”). (1) Obstacles Faced in Institutional Life illustrates the difficulties they faced during the recovery process. (2) Learning Diverse Coping Strategies to Manage Emotional Distress outlined the key methods and interventions they used to alleviate feelings of loneliness and helplessness. (3) Discovering Pathways of Emotional Resilience emphasized their capacity to explore new methods for maintaining emotional stability. (4) Exhibiting Anchors of Inner Strength focuses on their sources of hope and resilience while confronting internal challenges. (5) Rediscovering Meaning and Well-being in Recovery underscores their recognition of personal growth and improvement as they navigate their recovery. The findings from this study highlighted the role of Residential Care Facilities and their staff, such as nurses, social workers, and house parents, in addressing the fundamental needs of abandoned elderly individuals. In conclusion, the challenges in emotional and psychological state of abandoned elderly from past and present experiences had a significant impact in the speed of their recovery. This stressors and environmental factors altered their ability to cope that influence their mental health and the process of healing.
Copyright (c) 2026 Jamaica DC. Alcoriza, Regie P. De Jesus, Kathlen F. Canton, Fritzie Gay D. Mercado, Christian O. Mercado https://creativecommons.org/licenses/by-nc/4.0
The Relationship Between Case Manager Roles and Inpatient Operational Efficiency: A Cross-Sectional Study in Indonesian Referral Hospital
Background: Hospitals globally face increasing pressure to enhance operational efficiency without compromising care quality. In this context, the case manager role is pivotal, yet empirical evidence of its direct impact on quantitative efficiency metrics remains limited, particularly in developing countries. Objective: This study aimed to analyse the relationship between case manager roles and the operational efficiency of inpatient wards at a public referral hospital in Indonesia. Material and Method: A cross-sectional design was employed, encompassing all 39 head nurses selected via total sampling. Data were collected using a validated questionnaire on case manager roles (Cronbach's Alpha = 0.963) and an observation sheet for Barber-Johnson efficiency indicators (BOR, LOS, TOI, BTO). The Spearman Rho correlation test was used for analysis. Results: The results demonstrated that the overall efficiency revealed that a significant majority of inpatient wards were classified as inefficient. Furthermore, a significant relationship was found between the overall role of case managers and operational efficiency (p = 0.036). Analysis of sub-variables also revealed significant relationships: coordination of health services (p=0.009), communication (p=0.048), care planning (p=0.024), prevention of intervention duplication (p=0.025), and supervision (p=0.046). Conclusion: The study concludes that the case manager's role is significantly associated with key operational efficiency indicators. Optimising this role through structured training, clear protocols, and enhanced interprofessional collaboration is recommended as a crucial strategy for hospital management to improve resource utilisation and service quality.
Copyright (c) 2026 Zul Habibi, Irwan Saputra, Martunis, Hajjul Kamil, Said Usman https://creativecommons.org/licenses/by-nc/4.0
Knowledge on Antimicrobial Resistance and Stewardship in Undergraduate Nursing Students: A Cross-sectional study
Background: Antimicrobial resistance (AMR) is a global health threat, causing increased morbidity, mortality, and healthcare costs. Effective antimicrobial stewardship (AMS) is crucial to limit its spread. Nurses play a critical role in addressing AMR, but knowledge deficiency among undergraduate nursing students can hinder their preparedness for stewardship responsibilities. This study aims to determine the knowledge level of undergraduate nursing students about antibiotics, AMR, and AMS, addressing the challenge of knowledge deficiency among these students. Methods: A cross-sectional study was conducted on 140 undergraduate nursing students, using a self-administered questionnaire to collect demographic data and knowledge about antibiotics, antimicrobial resistance, and antimicrobial stewardship. Statistical analyses were performed using SPSS version 20.0, with descriptive statistics providing an overview of participants' knowledge and chi-square tests investigating associations between factors like age, gender, semester, and residence with knowledge. Results: Participants had the mean knowledge score of 7 ± 2.067, and none of the participants had adequate knowledge, 40.7% had moderately adequate knowledge, and 59.3% had inadequate knowledge. Semester of study was the only factor that had significant relations with knowledge on antimicrobial resistance and stewardship (p = 0.010). Conclusion: The study reveals significant gaps in undergraduate nursing students' understanding of antibiotics, antimicrobial resistance, and stewardship, highlighting the need for comprehensive curricular reform and innovative educational strategies to prepare future nurses for addressing antimicrobial resistance and strengthening healthcare systems.
Copyright (c) 2025 Sabina Chaudhary, Adarsh Lata Singh https://creativecommons.org/licenses/by-nc/4.0
The Effectiveness of Self-Help Group (SHG) Therapy in Preventing Drug Use Among Adolescents: A Cluster Randomized Controlled Trial
Objectives: This study explores the effectiveness of Self-Help Group (SHG) therapy in preventing drug abuse amongst adolescents. Methods: A Cluster-randomized controlled trial was conducted with with 80 junior high school students in Aceh, Indonesia. Participants were divided into intervention and control groups. The Intervention group underwent a six-week self-help group (SHG) therapy program. Outcomes including knowledge, attitudes, desire to use drugs, social support, and self-efficacy were assessed via self-report questionnaires. Results: The intervention group showed significant improvements in knowledge (p=0.001), attitudes (p=0.001), and a reduced desire to use drugs (p=0.001). There was no significant change in social support (p=0.139), but a significant decrease in self-efficacy (p=0.007). Conclusion: Self-help group (SHG) therapy is effective for enhancing knowledge and attitudes and reducing drug use intention among adolescents. Additional strategies are needed to strengthen social support and self-efficacy.
Copyright (c) 2025 Sri Jumiati, Teuku Tahlil, Marthoenis https://creativecommons.org/licenses/by-nc/4.0
Factors Related to Non-Nursing Tasks Among Staff Nurses in Provincial Hospitals in Aceh
Background: Non-nursing tasks, frequently performed by nurses despite not requiring professional training, are common in healthcare facilities worldwide. These additional responsibilities increase workload, negatively affecting care quality, healthcare worker well-being, patient safety, satisfaction, and overall efficiency. Objective: This study aimed to examine factors related to non-nursing tasks among staff nurses. Material and Method:A cross-sectional study was conducted in three hospitals in Aceh Province from December 2024 to February 2025. A total of 244 nurses were selected using proportional sampling to ensure accurate representation of the nursing population in each hospital. The sample selection used accidental sampling, choosing odd-numbered nurses from the shift schedule, provided they met the inclusion criteria. Results:The study found that 73% of nurses had performed non-nursing tasks, with the highest prevalence occurring during the night shift. The most frequently performed task was administrative duties (67.6%). Factors associated with non-nursing tasks included compensating the lack of resources, being pressed by the organizational culture, dealing unexpected clinical events, and protecting patients (p = 0.001), with compensating the lack of resources being the most dominant factor (OR = 4.2, 95% CI: 1.99–8.85, p = 0.001). Conclusion: Compensating the lack of resources is the primary factor driving nurses to perform non-nursing tasks as an adaptation to workforce limitations, organizational culture, and unexpected clinical situations, ultimately impacting patient care quality and nurse well-being
Demystifying Misconceptions and Myths Surrounding Menstruation among Secondary School Girls in Kano State, Nigeria
Background: Understanding menstrual health and hygiene is essential for the well-being of adolescent girls, yet misconceptions persist among secondary school students. Methods: A cross-sectional survey was conducted with 408 participants from four schools in Kano State, using random sampling to assess menstrual misconceptions. Data were analysed using descriptive and inferential statistics, including ANOVA. Results: The overall mean score of 2.35 indicates a high prevalence of myths and misconceptions about menstruation among participants. However, differences in misconceptions across schools were not significant (F = 2.460706, F critical = 2.866266, p = 0.078353). Conclusion: Educating students through awareness campaigns is crucial to dispel these myths, reduce stigma, and foster a better understanding of menstruation. Implementing comprehensive educational programs can empower young girls to manage their menstrual health confidently.
Lived Experiences of Postgraduate Diploma Community Nursing Students with Flipped Learning at the Higher Institute of Health Specialties: A Phenomenological approach
Background: Flipped learning is an innovative teaching and learning strategy that enhances student-centred learning. This study aimed to explore postgraduate diploma nursing students’ lived experiences with flipped learning in the Community Health Nursing Practice Program at the Higher Institute of Health Specialties in Oman. Method: A hermeneutic phenomenological qualitative approach was used in the study, and six Omani students were interviewed. Findings: Thematic analysis revealed four themes: procedural experience of flipped learning, perceived benefits and challenges, instructor-student roles, and comparison with lecture-based learning. Conclusion: The study findings revealed that flipped learning enhanced engagement, critical thinking, and independent learning, but posed challenges like increased workload. The study offers insights for curriculum reform and highlights the importance of contextualizing flipped learning within Arab nursing education to meet evolving educational and professional demands.
Copyright (c) 2026 Faiza Abdullah Al Zadjali, Fatema Thani Al Saadi, Amal Mubarak Al-Alawi, Lakshmi Renganathan https://creativecommons.org/licenses/by-nc/4.0
Prevalence and Occupational Determinants of Varicose Veins Among Nursing Students: A Cross-Sectional Study
Background: Varicose veins are dilated, twisted veins most commonly affecting the lower limbs and are often associated with prolonged standing and physical strain. Nursing students, due to the nature of their clinical training, may be vulnerable to developing varicose veins; however, limited data exist on its prevalence in this group. Objective: This study aimed to assess the prevalence of varicose veins and identify associated occupational risk factors among nursing students. Methodology: A descriptive cross-sectional study was conducted among 60 final-year nursing students from a nursing college in Bangalore, Karnataka, selected through purposive sampling. Data were collected using a self-structured questionnaire covering sociodemographic and occupational factors (e.g., standing duration, physical activity), along with physical examination for varicose vein symptoms. Prevalence was determined through a combination of self-report and visual inspection. Data were analysed using descriptive and inferential statistics (significance set at p < 0.05). Results:Varicose veins were identified in 23 of 60 participants (38%). Among those affected, 70% were female and 30% were male. Prolonged standing (over 6 hours per day) was significantly associated with the presence of varicose veins (p < 0.05). In contrast, prolonged sitting and lower levels of physical activity showed weaker, non-significant associations. Conclusion: The study highlights a notable burden of varicose veins among nursing students and underscores the need for preventive education and ergonomic interventions during clinical training.
Copyright (c) 2025 Anuja Srivastava, Harsh Rastogi, Nisha Yadav https://creativecommons.org/licenses/by-nc/4.0
The Relationship Between Professional Identity and Work Motivation Among Nurses at The Maternal and Child Hospital in Aceh Province
Objective: This study aims to examine the relationship between professional identity and work motivation among nurses at the Maternal and Child Hospital in Aceh Province. Specifically, it seeks to analyze how each domain of professional identity including values and ethics, knowledge, leadership, and professional comportment relates to nurses’ motivation in the workplace. Furthermore, the study intends to determine which of these domains has the most dominant influence on work motivation, thereby providing evidence-based insights for developing strategies to enhance professional identity and improve performance among nursing staff. Material and Method: This study employed a quantitative cross-sectional design conducted from January to March 2024 at the Maternal and Child Hospital of Aceh Province. A total of 142 implementing nurses were selected using total sampling based on inclusion criteria such as active registration, a minimum of one year of experience, and voluntary participation. Data were collected using two validated instruments: the Nurse Professional Identity Scale (NPIS), measuring four domains of professional identity (values and ethics, knowledge, leadership, and professional comportment), and the Unified Motive Scale (UMS), which assesses three components of work motivation (achievement, power, and affiliation) based on McClelland’s Human Motivation Theory. Data analysis was performed using chi-square tests to examine bivariate relationships and logistic regression to identify the most influential predictors of work motivation. Results: Of the 142 nurses surveyed, 65.5% reported high work motivation. Significant associations were found between work motivation and values and ethics (p = 0.002; OR = 3.425), knowledge (p = 0.093; OR = 1.946), and professional comportment (p = 0.001; OR = 4.166). Professional comportment was the strongest, while leadership showed no significant relationship. Conclusion: Professional identity is significantly associated with nurses’ work motivation, with professional comportment as the strongest predictor. Strengthening this identity may enhance motivation and care quality in hospital settings.
Copyright (c) 2025 Putri Nabilla, Hajjul Kamil, Darmawati https://creativecommons.org/licenses/by-nc/4.0
Analysis of the Current Situation and Influencing Factors of Career Adaptability of Intern Nursing Students
Objective To explore the current situation and factors influencing the career adaptability of nursing students in practice, and to provide a theoretical basis for career education of clinical nursing students. Methods: From October to December 2023, 189 nursing students from colleges and universities who were interning at a Class III, Grade A general hospital in Henan Province were selected as survey participants. The General Information Questionnaire and the Career Adaptability Questionnaire for College Students were used to investigate these nursing interns. Factors affecting the career adaptability of nursing interns were analyzed using single-factor and multiple linear regression analyses. Results: The career adaptability score of nursing interns was 132.77 ± 22.49. Single-factor analysis showed that whether parents were engaged in medical or nursing-related occupations and the reasons for choosing nursing had statistically significant effects on the career adaptability scores of nursing interns in future planning (p < 0.05). Multiple linear regression analysis revealed that whether parents were engaged in medical or nursing-related occupations and the reasons for choosing a nursing major were influencing factors of career adaptability among nursing interns. Conclusions: The career adaptability of nursing students is at a medium level. Specifically, whether their parents are engaged in medical or nursing-related occupations and the reasons for choosing a nursing major are influencing factors of career adaptability among nursing interns. It is recommended that nursing educators and clinical supervisors consider various factors to improve career resilience.
Evaluating the Impact of A Nurse-Led Sexual Violence Prevention and Health Promotion Intervention: A Quasi-Experimental Study in Northern Myanmar Camps
Objective: To evaluate the impact of a nurse-led sexual violence prevention and health promotion intervention on improving the knowledge, attitudes towards sexual violence, and awareness of help-seeking services among internally displaced people living in northern Myanmar camps. Background: Sexual violence is a widespread violation of human rights, especially affecting internally displaced persons, who are more vulnerable in such situations. Nurses are an important frontier in service delivery, and nurse-led interventions in their daily routine, such as health education, promotion, counselling, and treatment, are essential in preventing violence. Methods: A quasi-experimental study, pre-posttest design, with 154 men and women aged 18 to 49 from two camps in Kachin State, Myanmar. Participants were enrolled into two groups: intervention and control. The intervention group received nurse-led intervention integrated into their routine health promotion activities. Paired t-tests were analysed to find within-group changes, and independent t-testswere used to assess between-group differences. Results: The intervention group showed improvement from pre-intervention to post-intervention compared to the control group, knowledge (mean difference = 3.16, p < 0.001), attitudes toward sexual violence (mean difference = 1.72, p < 0.001), and help-seeking knowledge and service awareness (mean difference = 17.00, p < 0.001). Between-group analysis found no significant differences at baseline. However, post-intervention scores of the intervention group were higher than the control group for knowledge (p = 0.023), attitudes (p < 0.001), and help-seeking service awareness (p < 0.001), confirming the effectiveness of the intervention. Conclusion: The findings suggest nurse-led interventions significantly improve knowledge, attitudes, and help-seeking service awareness related to sexual violence among conflict-affected settings. The nurse-led study highlights the necessity of policy support, integration into routine health services, and more research to improve long-term and sustainability in various humanitarian settings.
Experiences of Sexual Harassment Among Lesbian, Gay, Bisexual, Transgender, and Queer University Students in Bangkok, Thailand
Background: Lesbian, gay, bisexual, transgender, and queer (LGBTQ) people are vulnerable to experience sexual harassment because of inequality and discrimination. This study investigated the experience of sexual harassment and associated factors among LGBTQ university students in Bangkok, Thailand. Methods: A cross-sectional was conducted among 355 undergraduate students from universities in Bangkok, Thailand, through snowball sampling using self-administered standardized questionnaires. Associated factors were examined using binary logistic regression. Results: The participants had an average age of 20 ± 2 years, and the majority consisted of gay men (30.7%) and lesbian women (18.6%). Nearly all participants (99.4%) had experienced one or more forms of sexual harassment in their lifetime, with 48.2% at a moderate level and 22.3% at a high level. Transgender individuals, higher monthly income, and frequent posting of pictures and occasional chatting with strangers on social media were more likely to experience sexual harassment while having fewer sexual partners, a moderate tolerant attitude, and a moderate perception of sexual harassment were less likely to experience it. Conclusions: In this study, LGBTQ students experienced sexual harassment. Institutions and student welfare organizations should urgently implement policies and programs for preventing and responding to sexual harassment among this group. Future research should focus on LGBTQ students across diverse socioeconomic backgrounds and various social/sexual behaviors.
The Effectiveness of Foot and Back Massage to Stabilize Hemodynamics in Patients Undergoing Hemodialysis: A Quasy Experiment
Objective: To determine the effect of foot and back massage on hemodynamic stability in chronic kidney disease (CKD) patients undergoing hemodialysis. Hemodynamic stability is essential for patients undergoing hemodialysis, as electrolyte disturbances and hypertension significantly impact their clinical outcomes. This study hypothesizes that foot and back massage could serve as effective non-pharmacological interventions to improve hemodynamic parameters, addressing an area with limited research evidence and aiming to enhance patient care. Material and Method: This study used pre-test and post-test method with non-equivalent control-group design, involving 46 patients divided into 2 groups, intervention group and control group (received routine care). The intervention began with a screening process and pre-test in both intervention and control groups. After the initial assessment, the intervention group began to receive the first intervention session. Foot and back massage interventions were carried out 6 times for 6 days with a duration of 13-15 minutes. Respondents in the control group received routine care.After completing six intervention sessions,post-test was conducted to assess changes in hemodynamics (systolic and diastolic blood pressure, heart rate, respiratory rate, and oxygen saturation). Results: There was a significant difference after the foot and back massage intervention on hemodynamics stability (Systolic and diastolic blood pressure, heart rate (HR), respiratory rate (RR), oxygen saturation (SPO2) before and after the intervention, with p < 0.05. Conclusion: There is a significant effect of foot and back massage interventions on hemodynamic stability (Systolic and diastolic blood pressure, heart rate, respiratory rate, oxygen saturation) in CKD patients undergoing hemodialysis
Perception of Nursing Teachers Regarding The Effect of Covid-19 On Clinical Training at Government Nursing College - Khartoum State – Sudan (2022)
Background: COVID-19 has impacted the nursing education system worldwide, especially clinical practicum for teachers and learners. To solve this problem, courses in nursing schools across the globe, including those in Khartoum, had to close their doors and meet the World Health Organization and the local guidelines for safety and continuity of Education during the pandemic. Objective: This research seeks to establish the effect of COVID-19 on the delivery of clinical nursing education in the Khartoum government nursing colleges. Methodology: A cross-sectional analytical study design was used, and the study’s participants comprised only 27 medical-surgical nursing teachers at the governmental nursing colleges in Khartoum. Data was collected using a self-administered online questionnaire created using Google Forms. The data was analyzed using the Statistical Package for Social Services (SPSS) Version 26. Frequency and relationship analyses were estimated using descriptive statistics and non-parametric and chi-square tests. Results: The study observed that COVID-19 had an adverse effect on the clinical exposure of nursing students, whereas teachers and students were also affected negatively. Teachers were highly concerned about getting infected during clinical training, though a significant association existed between concern about infection and teaching experience. Conclusion: Accordingly, this study finds that COVID-19 disrupted clinical practices for nursing students in Khartoum. Virtual simulations and hybrid models should be used in future pandemics to prevent discontinuity and decline in the quality of nursing education programs.