To synthesise barriers and facilitators to reducing sedentary behaviour among stroke survivors and map them to the Theoretical Domains Framework (TDF).

A scoping review conducted following Joanna Briggs Institute (JBI) methodology and reported in accordance with Preferred Reporting Items for Systematic Review and Meta-Analysis, Scoping Review extension (PRISMA-ScR) guidelines.

Nine electronic databases (PubMed, CINAHL, MEDLINE, Embase, PsycINFO, Web of Science, Cochrane Library, CNKI and WanFang) were searched from inception to May 2025. Grey literature was identified through Google Scholar and ProQuest. Updated research was conducted in July 2026.

Studies focusing on barriers and/or facilitators to sedentary behaviour among stroke survivors were included, with no restrictions on study design.

Two reviewers independently screened studies, extracted data and mapped identified barriers and facilitators to the Theoretical Domains Framework. Frequencies of domains were calculated to summarise distribution patterns.

49 studies were included. A total of 32 barriers and 17 facilitators were identified and mapped to 12 TDF domains. Barriers were reported more frequently than facilitators. The most frequently represented domains included Skills, Environmental Context and Resources, Beliefs about Capabilities, Beliefs about Consequences, Social Influences, Knowledge and Emotion. Common barriers included stroke-related physical and functional limitations, fatigue, inadequate knowledge, low self-efficacy, fear of falling, limited social support and environmental constraints. Key facilitators included sedentary behaviour education, higher self-efficacy, supportive social and physical environments, inpatient rehabilitation and behaviour change strategies that promoted more active lifestyles.

Barriers to reducing sedentary behaviour among stroke survivors include limited knowledge, low motivation, insufficient social support, negative emotions and beliefs and physical limitations. Facilitators include social support, positive beliefs and supportive environmental conditions. Future interventions should comprehensively address these multilevel factors to develop more tailored and feasible behaviour change strategies.

This study was registered with the Open Science Framework website (osf.io/ma8qp).

Decisions regarding life-sustaining treatment and end-of-life care are among the most ethically complex and emotionally challenging decisions encountered in emergency departments and intensive care units. Such decisions frequently involve uncertainty regarding prognosis, limited time for deliberation and situations in which patients may lack decision-making capacity, requiring family members or surrogate decision-makers to participate in the decision-making process. Shared decision-making (SDM) has increasingly been recommended as an approach to align treatment decisions with patients’ values and preferences. Decision aids are evidence-based tools designed to support informed and value-congruent healthcare decisions by presenting available options, potential benefits and harms and opportunities for values clarification. Although decision aids have been extensively studied in chronic disease management and preference-sensitive healthcare decisions, their use in life-sustaining treatment and end-of-life care in emergency and intensive care settings remains fragmented and has not yet been comprehensively mapped. This scoping review aims to identify and map the existing literature on decision aids and related interventions that support SDM for life-sustaining treatment and end-of-life care in emergency and intensive care settings.

This scoping review will be conducted in accordance with the Joanna Briggs Institute (JBI) methodology for scoping reviews and reported following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses Extension for Scoping Reviews (PRISMA-ScR). Electronic searches will be performed in PubMed, Web of Science, the Cochrane Central Register of Controlled Trials (CENTRAL), CINAHL and Ichushi-Web. Studies published in English or Japanese from January 2000 onwards will be eligible. Quantitative, qualitative, mixed-methods and descriptive studies addressing decision aids or related interventions designed to support SDM regarding life-sustaining treatment and end-of-life care among adult patients, family members, surrogate decision-makers or healthcare professionals in emergency and intensive care settings will be included. Two reviewers will independently screen studies, assess eligibility and chart data. Findings will be synthesised descriptively and presented in narrative and tabular formats.

Ethics approval is not required because this review will analyse data from publicly available literature and will not involve human participants. Findings will be disseminated through publication in a peer-reviewed journal and presentation at relevant scientific conferences.

Multidimensional frailty among community-dwelling older adults has emerged as an important issue in ageing research, given its close association with declines in health status, functional independence and overall quality of life. This scoping review aims to map longitudinal evidence on multidimensional frailty in community-dwelling older adults, including its measurement, prevalence, changes over time and associated risk factors. The findings will be used to generate insights for future research and inform the development of interventions targeting multidimensional frailty.

This scoping review will be conducted in accordance with the methodological guidance of the Joanna Briggs Institute and the framework originally proposed by Arksey and O’Malley. The primary objective is to identify longitudinal evidence on risk factors associated with multidimensional frailty in community-dwelling older adults. A comprehensive literature search will be performed across six electronic databases (MEDLINE, Embase, CINAHL, the Cochrane Library, Web of Science and Scopus), covering studies published from 1 January 2010 to the date of the final search (anticipated August 2026). Only peer-reviewed studies published in English and using longitudinal designs will be included. Study selection will be guided by the Population–Concept–Context framework. The review findings will be reported according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews (PRISMA-ScR) guidelines.

Ethical approval is not required for this review as it is based solely on analysis of data from previously published studies. The results are expected to contribute to the development of interventions targeting multidimensional frailty among community-dwelling older adults. Findings will be disseminated through peer-reviewed journal publications, academic conferences and scholarly forums.

Metastatic breast cancer is increasingly managed as a long-term condition, yet symptom burden and health-related quality of life (HRQoL) remain major patient-centred concerns. Electronic patient-reported outcome (ePRO) monitoring has shown promise in improving symptom surveillance and supporting more responsive care in oncology; however, evidence specifically relating to metastatic breast cancer remains fragmented and has not yet been systematically synthesised. This review, therefore, aims to evaluate the effects of ePRO monitoring on symptom burden and HRQoL in patients with metastatic breast cancer.

This systematic review and meta-analysis will include randomised controlled trials and non-randomised controlled studies involving adults with metastatic breast cancer. Eligible interventions will include ongoing ePRO monitoring delivered through digital systems or platforms during treatment or follow-up. Comparators will include usual care or non-ePRO-based follow-up. The primary outcomes will be symptom burden and HRQoL; secondary outcomes will include physical, role and social functioning, individual symptom domains, healthcare utilisation, treatment adherence or interruption, patient satisfaction and feasibility indicators. A comprehensive search will be conducted in PubMed, Embase, Web of Science, CINAHL and the Cochrane Library from database inception to the final search date, with the planned literature search to be conducted from July 2026 to December 2026. Additional searches of ClinicalTrials.gov and the WHO International Clinical Trials Registry Platform will also be undertaken. Two reviewers will independently perform study selection, data extraction and risk-of-bias assessment. Where studies are sufficiently comparable, meta-analysis will be conducted using random-effects models; otherwise, findings will be synthesised narratively.

Ethical approval is not required because this review will synthesise data from previously published studies and will not involve the collection of primary data from human participants. The findings will be disseminated through publication in a peer-reviewed journal and presentation at relevant academic conferences.

CRD420261383449.

In 2024, 30.4% of the German population had a migration background. People with migration-related language barriers face numerous challenges within the healthcare system, which can negatively impact their health outcomes. While language barriers affect healthcare in general, oncology represents a complex field in which effective communication is crucial. For people with cancer in particular, difficulties in understanding information, treatment options, and the healthcare system itself may hinder access to services. This increases the risk of complications, prolonged hospitalisations and readmissions. At the same time, there is little information about this group, and evaluations of structured services are lacking. This study assesses a nurse-led complex intervention focusing on structured information and ongoing support for people with cancer and migration-related language barriers.

The intervention is designed for people with cancer and migration-related language barriers and comprises three key elements: (a) continuous guidance provided by already existing roles of oncology nurse specialists, (b) a telephone interpreting service and (c) multilingual informational materials. We will assess the intervention’s effectiveness with a controlled before-and-after study. Assuming an effect size of d=0.5 and using a 2:1 allocation ratio with 80% power, we aim to recruit 126 people with cancer and migration-related language barriers (84 intervention; 42 control) for participation. We will assess the primary outcome psychosocial support needs assessed with the Psychosocial Risk Questionnaire (PSR) at admission, discharge, and 3-month post-discharge using paper-based or digital questionnaires. The secondary outcomes, such as knowledge, quality of life, anxiety and satisfaction, are measured alongside the primary outcomes and compare the distribution of items and scores using Student’s t-test (total scores) or the Wilcoxon rank sum test (individual items) at a one-sided significance level of 5%. We will use an embedded process and economic evaluation to examine the feasibility, acceptability and implementation of the intervention in line with the Medical Research Council guidance for process evaluations of complex interventions.

The Ethics Committee of the Faculty of Medicine, University of Cologne (No. 23–1303 and 24–1266), approved the protocol, and the study was registered in the German Clinical Trials Register. We will disseminate the results of the study through peer-reviewed publications and at academic conferences.

German Clinical Trials Register (DRKS00034749).

Nurse educators play an essential role in fostering scientific production, innovative thinking and research culture. However, studies on the experiences of academic nurse educators leading research and development (R&D) projects remain limited.

This study aims to explore the experiences of nurse educators serving as R&D project leaders and to gather their recommendations on project management.

A qualitative study using reflexive thematic analysis.

11 academic nurse educators from universities in Türkiye, selected using purposive sampling.

Data were collected through semi-structured individual interviews guided by a researcher-developed interview guide and a brief demographic information form. Contact was made with educators via email, and individual interviews lasting 30–40 min were conducted with those who agreed to participate in the study via Zoom. With the participants’ consent, the interviews were audio-recorded and transcribed verbatim. Data analysis was performed using Braun and Clarke’s reflexive thematic analysis method. Intellectus Statistics software Analysis software was used to analyse the qualitative data.

Four interconnected themes emerged from the analysis. Nurse educators described R&D project leadership as a transformative experience that enhanced academic visibility, professional identity, motivation and personal empowerment. Although participants reported significant bureaucratic, financial and psychological challenges throughout the project process, institutional support, interdisciplinary collaboration and effective teamwork facilitated successful project management. Participants also emphasised scientific preparation, originality, mentoring, resilience and time management as essential components for sustaining research leadership and professional development.

R&D project leadership is not merely an academic responsibility for nurse educators; it is a transformative process that empowers individuals, fosters leadership and supports professional development. These findings highlight the potential value of institutional mentoring, interdisciplinary collaboration and streamlined administrative processes in supporting research capacity and sustainability in nursing.

These findings may help strengthen research capacity, mentoring systems and evidence-based leadership practices in nursing education and clinical settings.

This study aims to examine newly graduated nurses’ first-year work experiences, their coping processes in response to reality shock and their perceptions of professional adaptation.

This study employed a descriptive phenomenological design.

The study was conducted in a university hospital in Turkey between October 2024 and March 2025.

The participants consisted of 10 new graduate nurses working in clinical units including emergency departments, intensive care units and medical and surgical services. Participants were selected using purposive sampling based on predefined inclusion criteria.

The study identified three main themes: ‘Reality Shock and Professional Challenges’, ‘Adaptation and Coping Process’ and ‘Professional Development and Job Satisfaction’. Participants experienced reality shock due to the theory–practice gap, heavy workload, fear of mistakes, communication problems and insufficient support. Support from experienced nurses, peer support and coping strategies facilitated adaptation, while increasing clinical experience improved professional competence, self-confidence and job satisfaction.

It is evident that the transition process for newly graduated nurses involves not only the development of clinical skills but also intense psychosocial adaptation processes. It is believed that structured orientation programmes, mentor support and supportive work environments can strengthen new graduate nurses’ professional adaptation processes.

To systematically synthesise qualitative evidence on the experiences of chronic heart failure (CHF) patients using mobile health (mHealth) tools for self-management and to identify factors influencing their acceptance and adherence, thereby informing the development of more patient-centred solutions.

Qualitative meta-synthesis.

A comprehensive search was conducted using terms related to mHealth, heart failure, self-management and qualitative research. Study quality was appraised using the Joanna Briggs Institute criteria for qualitative studies, and data were synthesised using thematic synthesis. The search covered the period from database inception to July 2025.

The following eight electronic databases were searched: PubMed, Ovid, CINAHL, Web of Science, PsycINFO, China National Knowledge Infrastructure, Wangfang and VIP

A total of 18 studies were included, yielding two integrated themes: factors influencing the use of mHealth tools and recommendations for their development.

Experiences of patients with CHF using mHealth underscore the need for a patient-centred paradigm in mHealth design. Codesigning tools based on patients’ real-world needs and preferences is crucial to promote sustained engagement and effective self-management. Healthcare professionals and developers should prioritise usability, personalisation and continuous support to enhance acceptance.

CRD420-25638367.

Although total knee arthroplasty (TKA) is effective in relieving pain and restoring function in patients with advanced knee osteoarthritis, postoperative recovery remains suboptimal for many patients due to insufficient engagement in care and rehabilitation. Patient participation in decision-making is a key determinant of treatment adherence and outcomes; however, heterogeneity in decision-making engagement among patients undergoing TKA has not been well characterised. This study aimed to identify latent profiles of decision-making engagement among Chinese patients undergoing TKA and to examine factors associated with different engagement profiles.

A cross-sectional survey was conducted between May and September 2024 at a tertiary hospital in Shanghai, China. Patients undergoing TKA completed questionnaires assessing sociodemographic characteristics, disease-related information and decision-making engagement. Latent profile analysis was used to identify distinct decision-making engagement profiles. Univariate analyses and multinomial logistic regression were performed to explore factors associated with different engagement profiles.

This study was conducted in a tertiary hospital in Shanghai, China, and included adult patients undergoing TKA.

Decision-making engagement profiles among patients undergoing TKA and factors associated with different engagement profiles.

A total of 316 patients were included in the analysis. Three distinct decision-making engagement profiles were identified: low engagement (71/316, 22.5%), moderate engagement (144/316, 45.6%) and high engagement (101/316, 32.0%), with mean total engagement scores of 97.82, 111.75 and 136.42, respectively. Household income, education level, area of residence and preoperative use of walking aids differed significantly across engagement profiles. Multinomial logistic regression showed that lower patient-perceived shared decision-making scores (OR=0.940, 95% CI 0.919 to 0.963; p

Distinct decision-making engagement profiles exist among Chinese patients undergoing TKA. Lower patient-perceived shared decision-making scores, lower awareness of medical decision-making and passive decision-making role preferences were associated with membership in less engaged decision-making profiles. Targeted interventions focusing on decision literacy and communication support may help enhance patient engagement in TKA care.

To map existing literature on nurses’ contributions to medical decision-making in hospital care, the factors influencing their involvement and how both nurses and physicians perceive this contribution.

A scoping review was conducted following Arksey & O'Malley’s framework and reported in accordance with the Preferred Reporting Items for Systematic Review and Meta-Analysis (PRISMA)-Systematic Review and Meta-Analyses extension for Scoping Reviews (ScR) checklist

A broad literature search was conducted in PubMed, CINAHL and the Cochrane Library. The initial search was performed in October–November 2023 and updated in December 2025, with no time or language restrictions.

Empirical studies were screened by two independent researchers and included if they reported on nurses’ involvement in or attempts to contribute to decision-making regarding medical treatments for adult patients in the hospital.

Data were charted using a predefined extraction form. Extracted data were coded, grouped and examined inductively to identify recurring patterns, which were discussed and refined by the two reviewers.

A total of 111 studies were included, encompassing a wide range of study designs and clinical settings. Studies have reported that nurses often contribute to decision-making in subtle ways during ward rounds, multidisciplinary meetings and informal interactions, drawing on their observations and advocating for patients’ interests. Nurses reported moderate involvement, while physicians acknowledged nurses’ expertise but did not consistently recognise their input. We developed a model that illustrates how the interplay between personal, organisational and cultural factors determines whether nurses’ clinically relevant observations are acknowledged and integrated into medical treatment decisions.

Nurses contribute to medical treatment decision-making in various but often subtle, ways. Unfortunately, their contributions are not consistently recognised within decision-making processes.

Music-based interventions are increasingly used as supportive, non-pharmacological approaches in clinical care, yet nursing roles are often described inconsistently and intervention terminology and reporting remain heterogeneous. This scoping review will map the available evidence on music-based interventions with an explicit nursing role, referred to collectively in this review as nurse-led music-based interventions, for patients or care recipients across clinical care settings, with attention to populations, nursing roles, intervention characteristics, reported outcomes and implementation issues.

The review will follow Joanna Briggs Institute (JBI) scoping review methodology and will be reported according to Preferred Reporting Items for Systematic reviews and Meta-Analyses extension for Scoping Reviews (PRISMA-ScR). Preliminary searches of MEDLINE, CINAHL, Embase, Scopus, Web of Science Core Collection, PsycINFO, CNKI, Wanfang Data and VIP Information were conducted on 4 May 2026 solely to validate the database-specific search strategies; the formal search has not commenced. Formal searches of these databases and planned grey literature sources will be conducted from 1 to 7 September 2026, with an update search in February 2027 and completion anticipated in March 2027. Eligible sources will report an explicit and identifiable nursing role in a music-based intervention. Primary roles will be classified using prespecified responsibility-based definitions as nurse-led, nurse-managed, nurse-coordinated, nurse-delivered, nurse-facilitated or multidisciplinary with an explicit nursing role; all reported nursing activities and multidisciplinary involvement will also be retained. Two reviewers will independently undertake each stage of study selection and data charting, with adjudication when consensus cannot be reached. Findings will be presented through descriptive summaries, evidence mapping, tabular displays and narrative synthesis.

Ethical approval is not required because this review will use published and publicly accessible sources. Findings will be disseminated through peer-reviewed publication and conference presentations.

The protocol was registered on the Open Science Framework on 11 April 2026 (https://osf.io/c6ytn)

Person-centred dementia care (PCdC) is widely recognised as a core principle of high-quality dementia care and is embedded in national and international dementia care guidelines. However, translating PCdC into routine practice in nursing homes (NHs) continues to pose a significant challenge. This reflects both the theoretical complexity of PCdC and the fact that its delivery relies less on discrete care techniques and more on an underlying organisational culture and shared approach to care. Implementing PCdC therefore requires an organisational perspective that acknowledges the interplay between staff, leadership and organisational conditions. Although several approaches exist to strengthen organisational capacity for PCdC, NHs often lack guidance on how to identify and apply approaches that fit their specific context. This study aims to develop a toolbox that supports NHs in systematically building the organisational capacity required to implement and sustain PCdC in their specific context.

The toolbox will be developed through three consecutive studies:

Study 1: An exploratory qualitative study of the perspectives of managers and staff in NHs on organisational capacity building (OCB) for implementing and sustaining PCdC.

Study 2: A co-design study involving workshops to develop a first version of the OCB toolbox, informed by insights from a preliminary scoping review (conducted separately and published as a protocol on Open Science Framework) and Study 1.

Study 3: A qualitative consensus-building study using a nominal group technique with stakeholders and PCdC experts to refine and finalise the OCB toolbox (validation phase).

The toolbox development is conceptualised as the development of a complex intervention and will therefore be informed by O’Cathain et al’s guidance for developing complex health interventions. While co-design principles guide the overall development process, Study 2 represents the dedicated co-design phase involving collaborative workshops, ensuring that the resulting OCB toolbox integrates research evidence with practice-based insights.

The Cantonal Ethics Committee Zurich confirmed that the study is exempt from formal ethical approval under the Swiss Human Research Act (Req-2025-00812). Findings will be disseminated through peer-reviewed publications, conference presentations and practice-oriented outputs, including a toolbox for NHs.

Hospitals across Europe are under pressure to recruit and retain a well-qualified nursing workforce amid ongoing shortages. The study aimed to assess the perspective of bachelor-qualified (BSN) nurses compared with vocationally educated nurses on the relative importance of various recruitment and retention (R&R) measures to determine tailored, suitable R&R measures according to BSN-specific needs.

A convergent mixed-methods study combining a survey and semi-structured interviews through triangulation, conducted as part of the BSN4Hospital study.

BSN and 3-year vocationally educated nurses were surveyed in 22 German hospitals with R&R strategies and above-average numbers of BSN. In addition, interviews took place with BSN, chief nursing officers (CNO) and nurse scientists and those working in strategic units (NSC/other).

The survey included items related to R&R (work environment, onboarding, salary, shift work, work-life-balance, leadership, roles, tasks), perceived importance and the top three R&R measures. Interviews focused on targeted R&R measures, implementation and challenges.

A total of 1856 nurses participated in the survey (282 BSN and 1574 vocationally educated nurses). Semi-structured interviews were conducted with 19 individuals (6 BSN, 8 CNO and 5 NSC/other). On recruitment measures, a significantly higher proportion of BSN (82.6% vs 52.7% of vocationally educated nurses, p

Several R&R measures specific for BSN were identified suggesting that a tailored approach is needed. An integrated management approach that recognises BSN qualifications can support workforce stability and high-quality patient care.

Hand expression is a manual method of milk expression that requires no equipment and is commonly used in the early postpartum period, particularly when direct breastfeeding is not possible or not effective. Randomised trials have reported mixed findings across different maternal–infant contexts. This review aims to synthesise randomised evidence on the effects of postpartum hand expression on expressed milk volume and breastfeeding outcomes.

We will include individually randomised parallel-group controlled trials involving human postpartum women expressing breast milk in the early postpartum period. The intervention is postpartum hand expression; comparators will include electric or manual pump expression and usual care without structured hand-expression training. We will search PubMed, Embase, CINAHL, PsycINFO, Web of Science and CENTRAL from inception, without language or date restrictions and also search OpenGrey, ClinicalTrials.gov and WHO ICTRP, plus reference lists. Two reviewers will independently screen studies, extract data and assess risk of bias using the Risk of Bias tool for randomised trials, version 2. Eligible outcomes include expressed milk volume, breastfeeding outcomes, supplementation, time to onset of copious milk secretion and maternal outcomes. Where appropriate, we will conduct pairwise meta-analyses, calculating risk ratios for dichotomous outcomes and mean differences or standardised mean differences for continuous outcomes with 95% CIs. Heterogeneity will be assessed using ² and I², with prespecified subgroup and sensitivity analyses. Certainty of evidence will be assessed using Grading of Recommendations Assessment, Development and Evaluation (GRADE).

This study will be based on previous research findings, so that ethics approval is not required. Data searching commences in June 2026 and expects to complete in January, 2027. The findings will be disseminated through peer-reviewed journals and academic conferences.

CRD420261327070.

Stroke is a severe cerebrovascular disease characterised by high morbidity, high recurrence rate, high disability rate, high mortality rate and significant economic burden. The unmet needs of stroke patients are universal and diverse and closely related to their health outcomes.

This protocol describes a mixed-methods systematic review to identify unmet needs in stroke patients. A comprehensive search will be performed in the following databases: PubMed, CINAHL, Embase, Web of Science, PsycINFO, CNKI, Wanfang Database and CQVIP. Google Scholar and ProQuest Dissertations & Theses Global were searched as grey literature sources. The search will target studies published in English or Chinese between January 2018 and April 2026. Quantitative, qualitative and mixed-methods study designs will be included. Two independent reviewers will conduct the selection process and cross-check the data extraction. The Mixed-Methods Assessment Tool (2018 version) will be employed to evaluate study quality. The convergent integrated approach and thematic synthesis will be used to synthesise and map extracted data to the social ecological model. The Grading of Recommendations Assessment, Development and Evaluation (GRADE) approach and the Confidence in the Evidence from Reviews of Qualitative Research (GRADE-CERQual) approach will be used for the certainty assessment of evidence.

Ethical approval is not required for this systematic review, as it will use data extracted exclusively from published studies and other publicly available sources. The findings of this review will be disseminated through publication in a peer-reviewed journal and presentation at relevant academic and clinical conferences.

CRD420261366175.

Self-management is a key component of effective chronic obstructive pulmonary disease (COPD) management and is mainly promoted through pulmonary rehabilitation (PR) programmes. However, less than 2% of patients participate in PR programmes. Among those who do, approximately 40% fail to complete the programme. The reasons for this are multifactorial and include dyspnoea, reduced exercise tolerance, lack of motivation and inadequate transportation and infrastructure to access PR centres. In this context, self-management digital health interventions emerge as a promising approach to support the development of self-management competencies, contribute to changing and maintaining behaviours and prevent a downward spiral of deconditioning in this population. The aim of this study is to evaluate the feasibility, acceptability and preliminary effects of a theory-based self-management digital intervention (Respir’air BPCO) designed to promote physical activity in patients with COPD.

This pilot randomised controlled trial will enrol 20 patients with COPD who are being followed at a Swiss pulmonary centre. Participants will be randomised using Global Initiative for Chronic Obstructive Lung Disease (GOLD) stage stratification (1:1) at the end of the in-person PR programme into either an experimental group receiving a mobile app-based self-management intervention aimed at promoting physical activity or a control group receiving only usual care. Data will be collected at three time points: immediately after completion of the PR programme (T0), 3 months post-PR (T1) and 6 months post-PR (T2). The study will assess trial methodological feasibility, including recruitment duration, consent rate, retention rate, acceptance of the allocated group and data completeness. Intervention feasibility will be evaluated through intervention fidelity, the number and type of technical problems reported by patients, and patients’ and/or researchers’ observations regarding the intervention design, content and use to inform future refinements. Intervention acceptability will be assessed using mobile app usage data and the Treatment Acceptability and Preferences questionnaire. In addition, preliminary effects will be evaluated through daily step count (pedometer), self-management (Self-Care in Chronic Obstructive Pulmonary Disease Inventory), motivational regulation of physical activity (Behavioural Regulation in Exercise Questionnaire-3), quality of life (St. George's Respiratory Questionnaire and EuroQol 5-Dimensions-5 Levels), severity of dyspnea (Modified Medical Research Council Dyspnea Scale) and the number of exacerbations and hospitalisations. Analyses will include descriptive statistics and estimation-based comparative analyses using generalised linear mixed-effects models under the intention-to-treat principle, which accommodate missing data under standard assumptions, with reporting of effect sizes and CIs.

The study protocol has been approved by the Ethics Commission of the Canton of Vaud (registration no.: 2025-01697). Results will be published in international peer-reviewed journals and presented at national and international conferences.

NCT07262229.

Compassionate care is a core ethical and professional value in nursing, especially in the context of elderly care, where vulnerability, chronic illness and relational dependency are at the forefront. Despite the growing international interest in compassion and narrative medicine, there is limited empirical research examining how nurses experience, construct and sustain compassionate care for older people in everyday practice, especially in Eastern European contexts. Narrative practices offer a valuable methodological lens for capturing the experiences, moral meanings and emotional dimensions of nursing care. The aim of this study is to explore how nurses understand, experience and implement compassionate care for older people and to explore the potential of narrative practices to illuminate facilitators, barriers and professional meaning-making in gerontological nursing.

A qualitative research design based on narrative inquiry and interpretive phenomenological analysis will be used. Semistructured narrative interviews will be conducted with registered nurses working with older people in institutional care settings. The interview guide is informed by international literature on compassionate care, narrative medicine, gerontological nursing and relational ethics. Data will be analysed using reflexive thematic analysis following Braun and Clarke’s six-phase framework supported by NVivo software. Narrative and interpretive elements will be integrated to explore both the content of participants’ stories and the meanings they attribute to their experiences.

The study was approved by the Ethics Committee of the Medical University of Varna (Approval No. 17, 3 July 2025). All participants will provide informed consent and confidentiality will be assured throughout the study. Findings will be disseminated through peer-reviewed publications, academic conferences and professional forums, with the aim of informing nursing education, practice and policy related to compassionate care for older people.

This study aimed to explore how young and middle-aged adults (aged 18–65 years) with multimorbidity and complex chronic conditions experience hospitalisation and the transition home.

In this qualitative study, semi-structured interviews were conducted. Data from the interviews were analysed using reflexive thematic analysis following Braun and Clarke (2022).

Two university hospitals in Switzerland (March to July 2024).

16 young and middle-aged adults with multimorbidity and complex chronic conditions from two university hospitals in Switzerland were selected as interview participants to gain an understanding of the experience of young and middle-aged adults with multimorbidity and complex chronic conditions within the hospital and on transition home.

Analysis of the interviews revealed four main themes that describe the experiences of younger and middle-aged adults with multimorbidity and complex chronic conditions during and after hospitalisation: experiences on a (1) physical, (2) emotional and psychological, as well as on a (3) social level and (4) the constant tension within the lived experience of illness; this constant tension in turn influenced the experiences of this patient group on a physical, emotional, psychological and social level. Conversely, these three levels influenced both the positive and negative experience of illness and the positive and negative anticipation surrounding it.

The study’s findings confirm that this patient group requires integrated care, a care model that goes beyond the disease-centred comorbidity perspective of previous care models that supports coordinated proactive care by an interprofessional core team and a central coordinator and that operates within and between the different health sectors. Advanced practice nurses are particularly well-suited for a leading role within integrated care models due to their advanced nursing skills and knowledge. These results could serve as an important basis for this specific role design. The results of this study also confirm that this patient group requires a complex, holistic and person-centred approach to care to have the opportunity to return to a normal life despite massive limitations. Mental health plays a central role, as it is an important influencing factor that should be given special attention during treatment. It is essential for healthcare systems and medical professionals to understand the burden of diseases in the context of physical, financial, family and social circumstances. Further research into the experiences of young and middle-aged adults with multimorbidity and complex chronic conditions is recommended.

Compassion is a core value in person-centred nursing and is essential in the care of patients with cancer. However, existing measurement instruments often fail to capture the cultural, ethical and relational dimensions of compassion as perceived by patients within specific sociocultural contexts. This study aims to develop and psychometrically evaluate the compassion perception in nursing care (CPNC) instrument for patients with cancer, reflecting the local sociocultural context of cancer care in Iran.

A sequential exploratory mixed-methods design (qualitative->quantitative) will be employed. For instrument development, the study will proceed through three sequential stages. Stage 1 will involve qualitative concept elicitation and development of a patient-derived conceptual model and operational definition of perceived compassion. Stage 2 will involve questionnaire development and mixed-methods content validity assessment. Stage 3 will comprise quantitative psychometric evaluation of the refined CPNC instrument. Content validity will be assessed through cognitive interviews, patient-based quantitative assessment and expert-based evaluation. Psychometric testing will include exploratory and confirmatory factor analyses, internal consistency, test-retest reliability, measurement error and interpretability assessment.

Ethics approval was obtained from the Research Ethics Committee of Tarbiat Modares University (IR.MODARES.REC.1404.033), and the study will be conducted in accordance with the principles of the Declaration of Helsinki. The findings will be disseminated through peer-reviewed publications and presentations at national and international oncology nursing conferences.

Internationally, nursing students’ awareness and familiarity with artificial intelligence (AI) remain a challenge as evidenced by the current literature. Interestingly, the Gulf Cooperation Council (GCC) region has earned a strong standing for driving national digital transformation; however, this ambition has not been translated into research. Despite growing interest in AI-driven healthcare, empirical studies examining nursing students’ readiness in these countries to operate in healthcare environments remain limited, representing a critical gap in the literature. Our initial literature review found a high degree of heterogeneity among study designs, measurement tools and theoretical framing and highlighted an unequivocal need for a rigorous and systematic synthesis to uncover consistent patterns, methodological gaps and contextual factors that shape nursing students’ engagement with AI.

This protocol aims to provide a structured plan for combining the current evidence on nursing students’ awareness, knowledge and attitudes regarding AI applications in nursing education.

This protocol is prepared in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analysis Protocols (PRISMA-P) 2015 guidelines, and it is registered with the international Prospective Register of Systematic Reviews (PROSPERO). A comprehensive and systematic search of the literature will be undertaken across four key electronic databases: PubMed, CINAHL, Scopus and Web of Science, using Boolean search strings constructed from Medical Subject Headings-controlled terms and free-text keywords encompassing six predefined thematic domains: AI applications in nursing education, student awareness, attitudes, technology acceptance, adoption, ethical considerations and regional context. All studies published in English between January 2020 and June 2026 including cross-sectional, cohort, quasiexperimental and qualitative studies will be included in this review. The primary outcome is nursing students’ awareness of and attitudes toward AI; secondary outcomes include AI-related knowledge, behavioural intention and ethical concerns. A 41-item standardised form will be used for data extraction across all included studies, systematically capturing study characteristics, instruments, theoretical frameworks, barriers, facilitators and the outcomes of interest. To assess the studies’ quality, we will use the Joanna Briggs Institute (JBI) Critical Appraisal Tools for quantitative and qualitative studies, ensuring a comprehensive and methodologically consistent appraisal process across all included studies. Narrative synthesis will be performed complemented by meta-analysis where applicable, organised by the construct domains and geographic regions. This protocol provides an in-depth, systematic review plan that will report the most thorough synthesis to date regarding nursing students’ awareness, knowledge levels and perceptions of the utilisation of AI within nursing education. The review will identify validated instruments for cross-cultural adaptation, establish benchmarks and estimate prevalence of awareness, knowledge and attitude. We will describe the theoretical and contextual contrived factors associated with these constructs in nursing students.

As this systematic review is based exclusively on published literature and does not involve the collection of primary data from human participants or animals, formal ethical approval is not required. Findings from this review will be disseminated through publication in a peer-reviewed journal and presented at relevant national and international nursing and healthcare conferences. The review is expected to generate evidence-based insights that will inform nursing curricula, guide institutional policy on AI integration and highlight the critical evidence gap in the GCC region, including Oman, thereby contributing to the advancement of AI-ready nursing education internationally. A key focus will be mapping geographic variation, with particular attention to the GCC region where empirical evidence remains sparse.

CRD420261320108.