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Parenting stress among clinical nurses has been associated with turnover-related outcomes. For many nurses, critical periods of career development and accumulated clinical responsibility overlap with reproductive and early parenting years. Features of nursing work may shape parenting stress through demands related to scheduling, workload, and limited flexibility.
Integrative literature review.
An integrative literature review was conducted following the methodological framework of Whittemore and Knafl. The final searches across three databases (CINAHL Complete, Medline, and Embase) were completed on May 14, 2026. Eligible articles were published in English, addressed parenting stress, and, when empirical, included nurses as a distinct population. Reporting followed PRISMA guidelines.
Eight articles met all inclusion criteria. Countries of origin included South Korea, Turkey, and China. Approximately 1667 nurse-parent participants were represented across the included studies. Main themes included as follows: (1) Work-Family Role Conflict and Parenting Stress, (2) Parenting Stress Across Career and Family Life Stages, (3) Parenting Stress and Nurse Workforce Outcomes, and (4) Organizational and Structural Contributors to Parenting Stress.
Parenting stress appears to be a relevant nursing workforce issue shaped by structural conditions of practice. The structure and demands of patient care may intensify parenting stress. Additional research is needed to examine the effects of parenting stress in clinical nurses and the implications for nurse retention.
Organizational and policy-level interventions (including family-friendly scheduling, accessible childcare, and structured peer support programs) may support workforce sustainability among nurse-parents.
The integration of robots into clinical practice requires careful consideration of their alignment with nursing workflows, patient needs, and clinical contexts. This scoping review aimed to support effective technology adoption by systematically identifying and classifying how robots are used in hospital-based nursing practice using standardized nursing terminology.
A scoping review following Arksey and O'Malley's five-stage framework.
A structured search was conducted in five peer-reviewed databases (PubMed, Web of Science, Cochrane Library, CINAHL, and EMBASE) for studies published between January 2019 and July 24, 2025. The data were analyzed to classify the types of nursing tasks supported by the robots. Robotic functions were classified into direct care, indirect care, and associated work using standardized nursing terminology, Hurst's framework, and the Clinical Care Classification system to provide a codified and structured analysis of nursing tasks.
A total of 40 studies were included in the final review. Thirty-three focused on direct care with robots, primarily supporting psychological, physiological, and functional care. The key interventions included coping support, emotional support, infection control, and vital sign monitoring. Only one study involved indirect care, and nine focused on associated work, such as errands and cleaning.
Robots are primarily used for direct care, such as emotional support and monitoring, while their role in indirect care—requiring professional judgment including documentation—remains limited. This suggests that future development should prioritize user-centered designs and ethical guidelines aligned with actual clinical needs. Properly implemented robotic technology will serve as a strategic tool to enhance nursing efficiency and improve practice environments amidst chronic workforce shortages.
By categorizing robotic functions using standardized nursing terminology, this review offers a structured understanding of how robots can support nursing. These insights help identify tasks that can be delegated to robots during crises, such as pandemics or staffing shortages, allowing nurses to focus on essential patient care.
Retractions in nursing are often framed as isolated instances of author misconduct or editorial failure. Drawing on recent longitudinal analysis of retracted nursing articles and the Journal Systems Framework (JSF), this Commentary argues that retractions are better understood as system-level signals reflecting differences in editorial capacity, governance, and infrastructure across journal systems.
Between 1997 and 2022, 123 nursing articles were retracted, with persistent concerns related to ethical violations, variability in retraction notice quality, delayed corrective action, and continued post-retraction citation.
Applying the JSF highlights how corrective capacity varies across journal systems, shaping the timeliness, transparency, visibility, and downstream amplification of retraction practices. High-profile retractions in flagship journals may reflect greater corrective capacity rather than uniquely severe ethical failure. Interpreting retractions as indicators of system stress, rather than moral anomalies, shifts attention from individual blame toward strengthening editorial infrastructure.
A systems-aware approach positions nursing scholarship to improve transparency, resilience, and trust as publication volume and complexity continue to grow.
Because nursing scholarship informs clinical care, education, and policy, failures in the scholarly record have implications beyond publishing itself. Greater understanding of retractions and corrective editorial processes can help strengthen trust in evidence used to guide nursing and health care practice.
To develop a machine learning model for predicting Taiwanese adults' intention to sign an advance directive (AD) and to identify the psychosocial, demographic, and system-level predictors relevant to culturally sensitive nursing. This study distinguishes between the reflective process of advance care planning (ACP) and the formal legal act of AD completion, addressing the need to understand cultural and system-level influences.
This was a cross-sectional quantitative study.
A survey was conducted with 1412 Taiwanese adults by using validated instruments, such as the Knowledge of Advance Care Planning Questionnaire and Advance Care Planning Attitude Scale. Data were analyzed using linear regression, random forest, and extreme gradient boosting models to predict the intention to sign an AD. A SHapley Additive exPlanations analysis was performed to interpret the model and investigate the effects of personal values and system-level barriers.
The extreme gradient boosting model outperformed the other models, with mean absolute error and root mean squared error values of 1.68 and 2.13, respectively. The SHapley Additive exPlanations analysis highlighted attitude toward ACP as the strongest predictor of signing intention. In addition to psychosocial factors, system-level factors such as procedural unfamiliarity and high consultation costs emerged as key barriers. Furthermore, older age and a higher number of children were associated with a weaker intention to sign an AD, reflecting a preference for informal family consensus over formal legal documentation.
Machine learning models effectively identify the interplay between personal attitudes, family dynamics, and institutional conditions that shape AD-related decision-making. The transition from ACP dialogue to formal AD signing is determined by both cultural values and structural factors.
Nurses should adopt a dual-track strategy—supporting advance care planning through family-inclusive dialogues and serving as “system navigators” to help patients overcome legal and financial barriers to advance directive signing. Data-driven insights from the present study may inform precise, culturally responsive interventions that honor patient autonomy.
Psychiatric settings are high-risk environments for violence. Coercive measures (CMs) and security technologies (STs) can be used to ensure safety. However, limited evidence exists on how Italian mental health nurses (MHNs) perceive the appropriateness of such practices and the influencing factors. This study aimed to fill this gap.
Cross-sectional study.
An online survey collected sociodemographic data and validated measures of depression, anxiety, stress, stigma toward mental illness, and humanization of care. The perceived appropriateness of various CMs and STs was rated on a 5-point Likert scale using a validated item set. Data were analyzed using descriptive statistics, bivariate tests, and multilevel mixed-effects linear regression.
A total of 707 MHNs participated in the study. CMs were considered moderately appropriate (mean = 3.56 ± 0.92), with pharmacological restraint and locked-door policies rated as more appropriate than physical restraint. STs were evaluated better (mean = 3.74 ± 0.95), with alarms and closed-circuit television judged more appropriate than body-worn cameras and metal detectors. CMs were considered less appropriate by non-believers (p = 0.009), head nurses (p < 0.001), and those in non-acute settings (p = 0.004), and more appropriate by those in Central Italy (p = 0.036), on daytime shifts (p = 0.042), and with higher stigma (p = 0.012). STs were considered less appropriate by males (p = 0.004), head nurses (p = 0.040), and more experienced MHNs (p < 0.001), and more appropriate by those in Southern Italy (p < 0.001) and in non-acute settings (p < 0.001).
MHNs consider CMs and STs moderately appropriate. Perceptions are influenced by both individual and contextual factors. Targeted training, anti-stigma education, and inclusive policies are needed to ensure ethical and evidence-based safety practices in psychiatric care.
Targeted education and training in mental health nursing, both continuing and post-graduate, are essential to support cultural change among MHNs and ensure the appropriate use of CMs and STs. Integrating anti-stigma initiatives and involving MHNs in policy development can strengthen clinical decision-making and foster safer, more ethical, and person-centred psychiatric care.
Patient safety is a global priority, as adverse events represent the 14th leading cause of morbidity and mortality worldwide. Among the most common complications in hospitalized adults are functional decline, pressure injuries, and falls, all of which increase hospital stays, healthcare costs, and mortality. Although these risks are typically assessed independently, their interaction has been scarcely explored, and the identification of integrated patient risk profiles could better guide nursing care.
To establish profiles of adult inpatients based simultaneously on their level of functional capacity, risk of pressure injuries, and risk of falls.
Cross-sectional observational study.
A total of 2.666 patients were admitted to adult inpatient units in a Spanish hospital.
Data from the Barthel, Braden, and Downton scales collected within 24 h of admission were analyzed. A hierarchical cluster analysis followed by the k-means method was used to classify patients. Relationship between profiles and clinical variables were explored through multiple correspondence analysis, and predictors for each profile were identified using multinomial logistic regression.
Three patient profiles were identified: profile 1 (low risk), minor dependency, low risk of pressure injuries and falls (68.5%); profile 2 (moderate risk), moderate dependency and intermediate risk (15.4%); and profile 3 (high risk), severe dependency with high risk of pressure injuries and falls (16.1%). Older age, female sex, and higher comorbidity were significantly associated with higher-risk profiles (p < 0.001).
Hospitalized adults can be reliably classified into risk profiles based on functional capacity and the risk of pressure injuries and falls.
The identification of combined risk profiles may potentially guide nursing strategies to enhance patient safety, support individualized care planning, and contribute to optimizing resource distribution in hospital settings.
Loss of functional capacity, pressure injuries, and falls are key nursing-sensitive indicators of care quality. Profile-based stratification offers a new framework for personalized, data-driven, and safety-oriented nursing care.
The identification of integrated risk profiles based on functional capacity, pressure injury risk, and fall risk may support more comprehensive nursing assessment in hospitalized adults. These profiles may help inform care prioritization, facilitate early identification of vulnerable patients, and contribute to more efficient allocation of nursing resources. Incorporating multidimensional risk stratification into clinical practice may enhance coordinated and patient-centered care planning.
The new Universal Health Insurance (UHI) reforms aim to improve equity and quality of healthcare delivery; however, their sustainability depends on engagement and retention of the nursing workforce. Psychological empowerment has been identified as a key factor influencing nurses' attitudes and work-related behaviors, yet the evidence on how it relates to job embeddedness among nurses working in the early phase of UHI implementation in Egypt remains underexplored.
This study aimed to assess the association between psychological empowerment and job embeddedness among nurses under the umbrella of the new Universal Health Insurance in Egypt.
A descriptive cross-sectional design was employed from August 2025 to November 2025. A total of 213 nurses working at Aswan Specialized Hospital, affiliated with the UHI system in Upper Egypt, were recruited. Data were collected using a demographic questionnaire, and psychological empowerment was measured using the Psychological Empowerment Scale, and job embeddedness was assessed using the Global Job Embeddedness Scale. Descriptive statistics, Pearson correlation analysis, and hierarchical linear regression were used for data analysis.
Among 213 nurses, the mean score of psychological empowerment was reported at high overall levels of 5.75 (SD = 0.77), particularly in the dimensions of competence and meaning, alongside moderately high levels of job embeddedness, with a mean score of 4.76 (SD = 0.89). Psychological empowerment showed a significant positive correlation with job embeddedness (r = 0.512, p < 0.001). In hierarchical regression analysis adjusting for demographic and professional covariates, psychological empowerment emerged as a strong and independent predictor of job embeddedness (β = 0.55, 95% CI: 0.398–0.701, p < 0.001), explaining an additional 16.5% of the variance after controlling for covariates (ΔR2 = 0.165). In adjusted analyses, the covariates were not independently associated with job embeddedness.
Psychological empowerment was positively associated with nurses' job embeddedness in the UHI implementation setting. Higher levels of empowerment-related factors were positively associated with greater embeddedness, suggesting their relevance to workforce engagement and retention during health system reform.
Our study findings highlight that psychological empowerment plays a crucial role in fostering nurses' job embeddedness, which is critical for sustaining workforce retention and stability. Enhancing supportive leadership and nurses' involvement in decision-making is critical, especially during the early phase implementation of the universal health insurance system reform.
Children on the move in the ECOWAS subregion are part of historical mobility networks shaped by structural poverty, inadequate services, and inequalities. Using the Structural Violence Theory framework, the review examines how economic, social service, and governance policies interact to both create the demand for migration and increase the risks faced by children on the move. The review has three research objectives.
Systematic literature review guided by PRISMA.
There was an overwhelming response of relevant literature sources. Literature from 1966 to 2025 on child migration, trafficking, displacement, and protection by ECOWAS was collected. Among the 987 sources identified through a literature search of central academic databases and institutional repositories, 56 met the selection criteria. Qualitative analysis was employed to evaluate the robustness of the sources based on their methods.
Findings indicate rising levels of children on the move, driven by independent migration from rural areas to cities and cross-border migration along traditional migration routes. Factors such as economic hardship, limited access to quality education, conflict, gender-related labor market conditions, and family dynamics are interconnected and play crucial roles. Children on the move are increasingly vulnerable to exploitation, labor dangers, trafficking, and social exclusion. While international, regional, and national frameworks set standards legally, their implementation remains inefficient.
Children on the move within ECOWAS are seen as an inevitable result of structural factors rather than isolated incidents. One policy implication of this analysis is to include children on the move within the ECOWAS mobility framework. Additionally, social protection programs for children need to be expanded in countries with high emigration rates.
Nurses and allied frontline providers are well-positioned to identify mobility-related risks, deliver trauma-informed, non-discriminatory care, document safeguarding concerns, and activate referral pathways for child protection, psychosocial support, and legal assistance.
Situation-specific theories (SSTs) have emerged as an important approach for bridging the gap between nursing theory, research, and clinical practice. Unlike grand or middle-range theories, SSTs address specific nursing phenomena within clearly defined populations or contexts. Since their introduction, SSTs have gained prominence as tools for uniting empirical evidence, patient experience, and theoretical guidance. The purpose of this article is to provide an updated synthesis of nursing SSTs published between 2015 and 2025, mapping their purposes, target populations, theorizing methods, and linkages to research and clinical practice.
A comprehensive literature search was conducted to identify SSTs published between 2015 and 2025. Five electronic databases were systematically searched using the keywords “situation-specific theory”. Only peer-reviewed, English-language primary studies describing the development, testing, or application of SSTs were included. Titles, abstracts, and full texts were reviewed against inclusion criteria, resulting in 23 eligible studies. Data were extracted into a standardized table summarizing study characteristics, purposes, target populations, theorizing methods, and practice or research linkages. Findings were synthesized narratively to identify recurring themes and methodological trends in SST development, providing an integrated overview of the current state and application of SSTs.
Five overarching themes were identified across the 23 studies: (a) Broadened Scope, (b) Purpose-Driven Theorizing, (c) Dynamic Theory Lifecycle, (d) Methodological Maturity, and (e) Integration Across Practice, Education, and Research. Based on these findings, five recommendations are proposed: (a) Creative and Innovative Methods, (b) Collaborative and Interdisciplinary Development, (c) Broad Theoretical Integration, (d) Sustain Multi-Source Synthesis, and (e) Ongoing Theory Testing and Refinement.
In summary, this review demonstrates that SSTs have evolved into dynamic, context-sensitive frameworks that unite theory, research, and practice. Continued innovation, interdisciplinary collaboration, and empirical refinement will be essential to sustain their relevance and strengthen nursing's theoretical and clinical foundations.
Utilizing SSTs in clinical settings may enhance the relevance and effectiveness of care by aligning interventions with the unique needs of particular patient populations or situations.
Healthcare workers (HCWs) are continuously exposed to stress and potentially traumatic experiences, as during the COVID-19 pandemic. This research aims to investigate the correlates and predictors of Post-traumatic growth (PTG), a positive outcome following adversity, in a group of HCWs during the COVID-19 pandemic.
Cross-sectional design.
The sample included 168 HCWs (almost 43% were nurses working in hospitals or aging facilities) who were assessed with the PTG Inventory (PTGI) and other indicators of psychological distress (DASS-21) and well-being such as the Positive and Negative Affect Schedule (PANAS), the Mental Health Continuum Short-Form (MHC-SF), and the Satisfaction with Life Scale (SWLS). Regression analyses were calculated to evaluate the relationships among variables.
PTG Inventory positively correlated with SWLS (r = 0.256, p < 0.001) and MHC (r = 0.315, p < 0.001), but no correlations with anxiety and depression emerged. Female gender (β = 0.248, p = 0.001), COVID-19 infection (β = 0.222, p = 0.003), and MHC Total score (β = 0.294, p = 0.008) predicted PTGI. Additionally, a significant curvilinear U-shaped relationship existed between DASS-stress and PTGI levels (β = 0.541, p = 0.021), meaning that PTG was lower at a medium level of stress.
During the pandemic PTGI in HCWs was more directly predicted by well-being indicators than distress. Prioritizing their well-being, especially in times of crises, could aid in managing stress and trauma in healthcare settings.
The Centre was established in March 2025 as a central repository to document the gaps in nursing workforce data needed to inform planning and policy development. To establish research priorities, an inaugural panel of Centre experts created 98 initial research questions (GNWC) across five domains: education, practice, regulation, policy, and systemic issues. Released in May 2025, the World Health Organization's (WHO) State of the World's Nursing 2025 (SOWN) provides updated worldwide nursing workforce data and global analysis. This study explores GNWC framework alignment with topics addressed in SOWN to affirm its direction and to augment research areas that are underrepresented.
A framework analysis was conducted to compare SOWN findings with the GNWC research question framework. Findings between the two reports were categorized to identify areas of convergence and divergence.
Thematic information was extracted from SOWN, and each GNWC question was examined in relation to the extracted information. Data were grouped by topic into five domains and classified according to thematic congruence. An iterative process was used to capture the consensus on alignment reached between the researcher and the panel of experts.
Varied thematic congruence was identified between SOWN and the five domains of the GNWC framework: Education, Practice, Regulation, Policy, and Systemic issues. Shared understandings of global challenges were evident in all domains, with both minor and major differences identified.
The analysis demonstrates substantial thematic congruence between the GNWC research question framework and SOWN across several domains. Areas of more limited coverage include Education and Systemic issues.
Identifying challenges and evidence gaps in the global nursing workforce helps set research priorities and develop evidence-based strategies to strengthen it, thereby improving patient access to care and health outcomes.
This scoping review explores the environmental impact of nursing interventions in acute care settings, focusing on waste reduction, energy consumption, and carbon emissions, while identifying nurse-led sustainability practices, assessment frameworks, and implementation barriers/enablers.
Guided by Arksey and O'Malley's framework and reported per PRISMA-ScR guidelines.
Data Sources: PubMed, CINAHL, Scopus, and Google Scholar were searched for peer-reviewed, English-language studies published between 2020 and 2025. Review Methods: A five-stage process was employed: (1) research question formulation, (2) comprehensive literature search, (3) study selection using the Population–Phenomenon–Context (PPC) framework, (4) data charting via a structured extraction form, and (5) thematic synthesis. Methodological quality was appraised using Joanna Briggs Institute (JBI) tools.
Of 400 identified records, 25 met inclusion criteria. Findings show nurses reduce environmental impact through reusable linen use (e.g., 496 kg/year ICU waste reduction), energy-efficient equipment, and improved waste segregation. However, time constraints, limited resources, and inadequate sustainability training impede consistent implementation. Awareness among nurses and students is moderate but rarely translates into practice.
Nursing interventions hold significant potential to reduce healthcare's environmental footprint. Embedding sustainability competencies into curricula and reinforcing them with institutional policies and leadership support are essential.
This review informs nurses and clinical leaders that sustainable practices—such as switching to reusable linens and optimizing energy use—are both feasible and impactful in acute care. It provides actionable evidence for reducing waste and carbon emissions while maintaining patient safety, supporting the integration of environmental stewardship into daily nursing practice. Findings from this review highlight the measurable environmental benefits of nurse-led sustainability interventions, such as waste reduction and energy conservation in ICUs. The evidence supports updating nursing curricula, clinical guidelines, and hospital policies to equip nurses with the knowledge and tools needed to lead sustainability efforts, thereby reducing healthcare's carbon footprint without compromising care quality.
In Taiwan, engagement in professional help-seeking among persons living with schizophrenia remains limited despite increasing demands on mental healthcare systems. Clarifying the factors that shape professional help-seeking attitudes is essential for promoting recovery-oriented care. This study examined the correlates of professional help-seeking attitudes in persons with schizophrenia in Taiwan.
A cross-sectional correlational study.
A total of 144 persons receiving psychiatric rehabilitation care at three hospitals in Taiwan were recruited. Data were collected using structured self-report measures assessing sociodemographic and clinical characteristics, schizophrenia literacy, internalized stigma, and professional help-seeking attitudes. Descriptive statistics, bivariate analyses, and hierarchical multiple regression analyses were conducted.
Participants generally reported unfavorable attitudes toward professional help-seeking. More favorable attitudes were associated with higher educational attainment, shorter illness duration, greater schizophrenia literacy, and lower internalized stigma. Schizophrenia literacy and internalized stigma showed the most robust relationships with professional help-seeking attitudes.
Within Taiwanese mental healthcare settings, schizophrenia literacy and internalized stigma appear to be central to attitudes toward professional help-seeking among persons living with schizophrenia.
Routine assessment of schizophrenia literacy and internalized stigma, together with culturally sensitive and recovery-oriented nursing interventions, may enhance treatment engagement among persons living with schizophrenia. The findings may also inform mental health nursing practice in other cultural and healthcare contexts where limited schizophrenia literacy, stigma, and long-term inpatient care pose barriers to recovery-oriented care delivery.
Spirituality is a crucial yet complex element of holistic nursing care, particularly when providing care for older adults with depression. In Thailand, depression poses a significant mental health challenge. Thai cultural values are deeply interwoven with individuals' beliefs, making spirituality a critical factor in addressing the care of older adults with depression. This study aimed to explore how older adults with depression experience spirituality and construct meaning from it in their daily lives.
An interpretative phenomenological study.
In-depth interviews of 30 older Thai adults living with depression (aged 60–85 years) from an outpatient psychiatric clinic in southern Thailand were conducted using semi-structured interview questionnaires. Interpretive phenomenological analysis was employed. Data were collected from June to August 2024.
Five themes emerged from the phenomenological data analysis: (1) elusiveness of spiritual meaning, (2) holding oneself together through inner power, (3) finding acceptance through faith in a higher power, (4) family ties shaping peace and despair, and (5) being guided and cared for.
This study highlights that older adults with depression perceive spirituality as essential for their well-being. Personal practices, such as meditation and chanting, played a key role in strengthening spirituality and reducing the risk of relapse in depressive symptoms, which are distinct for each older adult. Understanding spirituality's role in mental health guides nurses to develop strategies for providing more empathetic spiritual care.
Nurses must address depression in older adults through individualized practices to effectively empower their inner strength and coping mechanisms. Understanding each individual's spiritual practices is essential to help them harness their inner strength when coping with depression.
The multifaceted responsibilities borne by clinical facilitators can impose a significant strain on their mental and emotional health and well-being. Within nursing and other healthcare professions, the responsibilities of clinical facilitators extend beyond conventional clinical duties to encompass supervising, facilitating, assessing, and supporting students as they transition into professional nursing practice. There is a need for insights into the well-being of clinical facilitators in the face of demanding work conditions, limited resources, and the emotional toll of patient care. This article critically reviews the literature to determine the current state of mental well-being among clinical facilitators in undergraduate health professions education and how they should be supported.
A scoping review guided the study using the Population, Context, Concept framework with a search string incorporating associated Boolean operators. 233 records were retrieved from eight databases and reviewed according to the inclusion and exclusion criteria. A total of 13 full-text articles were found to be eligible for extraction and analysis.
Major findings resulted in thematising mental health issue characteristics according to high and low job demands and burnout. Literature outlined the causes of mental health issues, including lack of recognition and appreciation, work performance, teaching and learning practices, student characteristics, support structures, and the environment. Recommendations included training, appropriate support systems, workload, guidelines, monitoring, community of practice, and research-oriented support.
Educational institutions must move beyond ad hoc support and implement integrated, strategic initiatives grounded in the principles of the Job-Demand-Control model. Future research should focus on developing and rigorously evaluating multifaceted intervention programmes that address these systemic factors. By investing in the well-being of clinical facilitators, institutions ultimately invest in the quality of future healthcare providers and the safety of the patients they will serve.
This article sets the tone for factors to consider and provides recommendations for educational institutions to better support the mental well-being of clinical facilitators.
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