The complexity of modern healthcare has driven an increase in the complexity of the preregistration nursing curricula. Diverse learning needs in this population are best served by inclusion of diverse approaches to teaching. Gamification offers an approach to enhance motivation and engagement, allowing for sustained motivation to keep learning. However, current research concerning gamification within preregistration nursing is still limited, particularly surrounding underlying design and the impact this has on long-term engagement and motivation. The aim of this scoping review is to identify and map gamification design elements used in preregistration nursing education, using the Octalysis framework, and to evaluate how these designs influence student engagement and motivation.

This scoping review will use the updated Joanna Briggs Institute Scoping Review Methodology and will be reported in accordance with Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for scoping reviews (PRISMA - ScR). The search will be conducted using Medical Literature Analysis and Retrieval System Online (MEDLINE), Cumulative Index to Nursing and Allied Health Literature (CINAHL), Education Resources Information Cente (ERIC), EBSCO, Web of Science Core Collection, PROquest, SCOPUS, Excerpta Medica Database (EMBASE) and PsycINFO. Grey literature, conference proceedings and relevant digital platforms will also be considered. Two reviewers will independently screen titles/abstracts and full texts. Data extraction will include gamification design elements, engagement and motivation outcomes and their alignment with the Octalysis framework. Synthesis and presentation of findings will be completed using the Patterns, Advances, Gaps, Evidence for practice, Research recommendations framework. The planned start for performing the scoping review is November 2025.

Ethical approval is not required as this review will synthesise published and publicly available evidence. Findings will be disseminated via peer-reviewed publication, conference presentations and stakeholder engagement within higher education.

While needs assessment is the starting point of good quality care, there is anecdotal evidence of patients receiving different care in similar circumstances. This study aims to investigate whether practice variation exists in needs assessments conducted by home care nurses and to identify the factors influencing these assessments.

A cross-sectional, quantitative retrospective study.

Primary care; home care nursing in the Netherlands in 2023.

Sampling was based on criterion sampling. Home care organisations were approached based on the following inclusion criteria: organisations providing home care nursing in the Netherlands, organisations from various regions of the country and organisations offering different types of home care nursing (eg, paediatric or palliative care), funded under the Dutch Health Insurance Act (Zvw). Organisations were excluded if they provided home care nursing funded by sources other than the Dutch Health Insurance Act. Home care nurses were recruited from participating organisations, each of whom had recently assessed the care needs of at least five patients. In total, 28 organisations and 258 home care nurses participated in this study, thereby yielding data from 1615 patients.

Assessed and delivered minutes of home care per patient per week.

Variation was primarily associated with patient-related factors. After accounting for these factors, 83% (assessed minutes) and 88% (delivered minutes) of the total variation was attributed to the patient level, 8% (assessed minutes) and 10% (delivered minutes) to the home care nurses’ level and 9% (assessed minutes) and 2% (delivered minutes) to the organisational level. Due to inadequate documentation in electronic health records, many missing values were identified.

The lack of nursing documentation suggests that missing factors may have contributed to variations in needs assessments. Thus, further research should comprehensively explore the patient-related factors currently absent from nursing documentation.

This study aims to categorise health behaviours in patients with lower limb deep vein thrombosis and explore the factors that influence these behaviours.

A cross-sectional study.

This study was conducted in four tertiary general hospitals in Urumqi, China.

This study included a total of 544 participants.

Self-rated abilities for health practices, health behaviour motivation, social support and health behaviour were the primary outcome measures.

Model 3 demonstrated superior fit across indices, supported by an Entropy value of 0.806 and a significant bootstrap likelihood ratio test (p

Three latent health behaviour subgroups, namely low, moderate and good, were identified among patients with lower limb deep vein thrombosis following hip or knee arthroplasty. Self-rated abilities for health practices, health behaviour motivation and social support were associated with these subgroups. These findings may provide preliminary insights for developing targeted interventions to support health behaviour improvement in this patient population.

To explore the relationships among continuity of care needs, patient empowerment and eHealth literacy in patients with stable chronic obstructive pulmonary disease (COPD), and to further identify the potential mediating role of eHealth literacy.

Cross-sectional study.

A tertiary care hospital (Level 3A, the highest level in the Chinese hospital classification system) in Shanghai, China.

The study participants consisted of 219 patients with stable COPD who visited or underwent follow-up at the outpatient clinic between December 2023 and May 2024.

The Continuity of Care Needs Questionnaire, COPD Patient Empowerment Evaluation Scale and eHealth Literacy Scale (eHEALS) were used to assess 219 patients with stable COPD. Univariate analysis, Pearson correlation analysis and mediation analysis were performed.

The mean Continuity of Care Needs score was 24.17 (SD=2.74), with medication guidance needs being the highest-scoring domain. The COPD Patient Empowerment score was 84.37 (SD=11.58), and the eHEALS score was 23.37 (SD=6.06). Pearson correlation analysis showed that continuity of care needs were negatively correlated with patient empowerment (r=–0.930, 95% CI –0.946 to –0.910) and eHealth literacy (r=–0.976, 95% CI –0.982 to –0.969), while patient empowerment was positively correlated with eHealth literacy (r=0.919, 95% CI 0.895 to 0.937) (all p

Patients with stable COPD demonstrated high continuity of care needs, with eHealth literacy partially mediating the relationship between patient empowerment and continuity of care needs. Healthcare providers should consider patients’ eHealth literacy to enhance patient empowerment and develop personalised continuity of care strategies.

Despite the increasing interest in wearable devices for monitoring body temperature in acute hospital settings, their integration into routine clinical workflows remains limited. There is a growing need to map the existing evidence on the use of temperature data generated by wearable devices to enhance our understanding of how these data are monitored, presented and used in clinical practice.

A scoping review of relevant literature from January 2013 to February 2025 will be conducted following the Joanna Briggs Institute scoping review methodology. A search of Medline, Embase, Web of Science, CINAHL and IEEE Xplore Databases will be undertaken using the Population, Concept, Context framework to identify studies that use wearable devices to monitor patients’ body temperature in acute hospital settings to support the management of fever or infections. A pilot search has been conducted to identify key search terms and specific types of wearable devices, followed by analysis of retrieved literature. We will use a two-step screening process to identify eligible articles, starting with title/abstract screening, followed by full-text screening. A hand search of the reference lists and citation lists of eligible articles and identified reviews will be conducted for additional publications that meet the inclusion criteria. Primary studies published in English and Chinese will be included regardless of their design and type of publication. Information on the characteristics of wearable devices, clinical contexts of device usage, strategies of presenting and analysing temperature data, and their integration into clinical workflows will be extracted. In the article presenting the results of the scoping review, we will provide a descriptive synthesis of the findings, supported by visual representations, such as charts, tables and images to describe the current evidence base.

As this is a scoping review, ethical approval is not required. The results will be presented in a peer-reviewed journal article and at healthcare or medical informatics conferences. The findings will provide insights into the interpretation of temperature data generated by wearable devices to support clinical decision-making and inform strategies to facilitate their incorporation into clinical practice.

This scoping review protocol is registered on Open Science Framework (https://osf.io/v6sp8).

Work stress is a threat to the well-being of nurses in China and also globally, and many studies have been conducted on the risk factors for stress symptoms. However, research on the process and mechanism between work environment risk factors and perceived stress symptoms among nurses remains limited. This study aimed to examine the direct and indirect relationships between nurse-rated structural empowerment, professional competence, thriving and nurses’ perceived stress symptoms.

This was a cross-sectional correlational study.

This study was conducted between April and October 2023, and 2172 nurses at three general hospitals in a Chinese province were recruited.

A questionnaire that included demographic information, the Conditions of Work Effectiveness Questionnaire, the Nurse Professional Competence Scale, the Thriving at Work Scale and one factor from the Psychosomatic Health Aspects Questionnaire that measured perceived stress symptoms was used. The PROCESS macro (model 4) with a parallel mediation model and bootstrapping tests was conducted to examine the direct and indirect relationships of structural empowerment, professional competence and thriving at work on perceived stress symptoms.

The regression analysis showed that structural empowerment, professional competence and thriving at work were negatively related to stress symptoms (β=–0.42, p

Structural empowerment was related to stress symptoms both directly and indirectly via professional competence and thriving at work. The findings suggest that managers should alleviate nurses’ stress symptoms through measures aimed at providing access to empowering structures, strengthening professional competence and promoting thriving at work.

Although individuals with dementia who reside in nursing homes are particularly susceptible to developing delirium, this condition is rarely recognised in these settings. Detection of delirium requires validated and reliable tools for this setting that can be applied by nursing staff. The primary objective of the study is to assess the comprehensibility, practicality and inter-rater reliability of two delirium detection tools (4 A’s test (4AT) and 4-item delirium superimposed on dementia (4-DSD)) and one tool for assessing both the diagnosis and severity of delirium (Delirium Rating Scale-Revised-98 (DRS-R-98)) in people with dementia who reside in nursing homes when used by nurses.

The comprehensibility and practicality of the German versions of the 4AT, 4-DSD and DRS-R-98 will be evaluated using cognitive interviews in accordance with the consensus-based standards for the selection of health measurement instruments framework. On the basis of the results of the cognitive interviews, a manual for each of the three tools will be developed and finalised by an expert panel. Finally, the inter-rater reliability and measurement error of the three tools will be determined using the manuals. For this purpose, a total of 70 residents from six nursing homes will be assessed by at least two nurses. The data analysis will include descriptive statistics and inter-rater reliability assessment for individual items (kappa value) and total scores (Intraclass correlation coefficients).

This study will assess the comprehensibility, practicality and inter-rater reliability of the 4AT, 4-DSD and DRS-R-98 for use in residents with dementia in nursing homes. The project was approved by the medical ethics committee of the University of Oldenburg (reference number: 2025-093).

The inter-rater reliability study was registered in the German Clinical Trials Register. Registration number: DRKS00037458 (https://www.drks.de/search/de/trial/DRKS00037458/details).

To explore the levels of health-related functioning during pregnancy and postpartum and its association with non-severe maternal morbidities.

An observational longitudinal study.

A tertiary women’s hospital in urban China.

Pregnant women in late pregnancy were recruited via consecutive sampling. The Chinese version of the Women’s Outcome Instrument for maternal healthCarE instrument was applied to measure health-related functioning and maternal morbidities at 28–41.6 weeks of gestation and at 6 weeks postpartum. Main outcome measures included health-related functioning, physical symptoms, anxiety and depression.

Among the 624 participants, health-related functioning scores were significantly higher during late pregnancy than at 6 weeks postpartum (16.33±4.78 vs 14.40±3.65, p

Functional impairment is prevalent perinatally and associated interactively with maternal morbidities. Assessment of health-related functioning and the provision of targeted interventions are recommended to improve maternal health outcomes in the perinatal period and beyond.

This study was conducted to examine the relationship between exercise health beliefs, happiness and quality of life among pregnant women, and to evaluate how sociodemographic characteristics are associated with these variables.

The study was conducted using a cross-sectional descriptive study design. Data were collected through face-to-face interviews using a convenience sampling approach. ‘Personal Information Form’, ‘Exercise Health Belief Model Scale’, ‘Oxford Happiness Scale Short Form’ and ‘Short Form (SF-12) Quality of Life Scale’ were used to collect data. Descriptive statistics (mean, SD, percentage), Pearson correlation analysis and simple linear regression were applied.

The study was conducted at Family Health Centres located in a provincial centre in Eastern Turkey.

A total of 1090 pregnant women who visited the Family Health Centres participated in the study.

The mean score for the Exercise Health Belief Model Scale was 113.98±20.49, the mean score for the Oxford Happiness Scale Short Form was 18.45±4.05 and the mean score for the SF-12 Quality of Life Scale was 85.34±10.29. A positive and moderately significant correlation was found between exercise health beliefs, happiness and quality of life (r=0.31–0.38, p

Higher levels of exercise health beliefs were associated with increased happiness and quality of life in pregnant women. These findings suggest that nursing interventions aimed at strengthening exercise beliefs may contribute to maternal well-being during pregnancy.

To examine the association between workplace sexual harassment and post-traumatic stress disorder (PTSD) symptoms among nurses in southeast Iran.

Cross-sectional study.

Four teaching hospitals affiliated with Kerman University of Medical Sciences, Iran.

A total of 283 female nurses with at least 1 year of clinical experience participated in the study.

Data were collected using convenience sampling and assessed using a demographic questionnaire, the Nurses’ Sexual Harassment Questionnaire, and the Impact of Event Scale-Revised (IES-R). Non-parametric tests, Spearman’s rho correlation and multivariate logistic regression were used for analysis.

Overall, 39.1% of nurses reported experiencing sexual harassment sometimes to always. A total of 13.4% screened positive for PTSD. Sexual harassment was significantly associated with PTSD symptoms (OR: 1.26; 95% CI 1.164 to 1.364). Younger, single and less experienced nurses reported higher harassment levels, though sociodemographic variables were not associated with PTSD.

Workplace sexual harassment was significantly associated with increased PTSD symptoms among nurses. While demographic factors were related to harassment exposure, they were not linked to PTSD. Findings highlight the importance of preventive organisational strategies to mitigate harassment and protect nurses’ mental well-being.

Although the UK is a multicultural society, racially minoritised populations are often under-represented in healthcare research owing to the significant barriers to participation they experience.1 Under-representation of racially minoritised groups in research impacts the quality of evidence and applicability of findings to these groups. This, in part, explains why these communities are more likely to report poorer health and poorer experiences of using healthcare services than their White counterparts,2 given that their cultural and spiritual preferences are often ignored.3 This commentary will explore some of the persistent multifaceted barriers and the role of research ethics committees (RECs) in enabling inclusive healthcare research among racially minoritised communities, given their key responsibility in building public confidence, ensuring ethical conduct and safeguarding research participants. In addition, patient and public involvement and engagement (PPIE) can complement the roles of RECs in embracing diversity in healthcare...

Vital signs are essential markers of a patient’s physiological state, and these include heart rate, temperature, blood pressure, oxygen saturation, respiration rate and level of consciousness. Consequently, accurate assessment, documentation and interpretation of these markers are vital for early detection of patients’ deterioration and timely intervention.1 2

Stroke nursing is widely recognised for its significant role across the whole multidisciplinary stroke care pathway.1 Ensuring that stroke nurses are equipped with the latest stroke specialist knowledge and skills is fundamental in providing high-quality and safe stroke care.1 2 However, in spite of the provision of nationally-recognised, quality-assured training and education programmes, for example, the Stroke-Specific Education Framework in the...

Shortages in the nursing workforce impact on the quality of patient care and pose a complex challenge for governments and healthcare organisations across the globe. There are estimated to be approximately 29 million nurses worldwide as of 2020, with a shortage of approximately 7 million against required levels. Despite growth in the workforce over the coming years, the nursing shortage is still projected to be 4.5M by 2030.1

One approach to addressing...

Sepsis is a life-threatening response to infection and remains a critical challenge with high morbidity and mortality rates. The Surviving Sepsis Campaign (SSC) guidelines serve as a cornerstone for sepsis management and are pivotal in standardising care. Taylor et al’s article1 scrutinises the real-world implications of updated SSC antibiotic timing recommendations2 and offers critical insights into the practical effects of the revised antibiotic timing guidelines.

Climate change is increasingly harming human health. Extreme weather events cause devastation, low crop yields and failure, contributing to food insecurity, economic hardship and resource shortages. Rising temperatures also increase the spread of infectious diseases and epidemics. Globally, countries are using healthcare services as an initial method of addressing these challenges.2 However, healthcare systems are major...

Type 2 diabetes mellitus (T2DM) is a significant public health issue, with diet playing a crucial role in its management.1 Food insecurity, defined as the lack of consistent access to enough food for an active, healthy life, exacerbates this condition, making effective dietary interventions critical.2 Food-as-medicine programmes, which provide medically tailored meals and nutritional education, aim to improve health outcomes for individuals with chronic diseases.2 The study...

Diabetes is a widespread chronic disease, with steadily rising prevalence in most countries. In 2019, the global prevalence of diabetes was estimated at 9.3%, affecting 463 million people. This figure is projected to rise to 10.2% by 2030 and 10.9% by 2045.2 All people with type 1 diabetes and many people...

People living with Long Covid often find the complexity of navigating health services difficult. The nurse’s role is to support patients in this context. This includes ensuring they are sufficiently informed about what Long Covid is. The specialist nurses recommended the British Heart Foundation’s online resource - Long Covid: Symptoms, tests and treatments: https://www.bhf.org.uk/informationsupport/heart-matters-magazine/news/coronavirus-and-your-health/long-covid%23whatdoesfatiguefeel.

Information about Long Covid is also available via Long Covid Physio: https://longcovid.physio/

Every person...