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Stroke is a global health concern. A timely response to a stroke can help reduce morbidity and mortality. However, barriers to timely response include poor recognition of stroke symptoms. Stroke symptom messages are designed to increase stroke recognition and encourage individuals to seek urgent medical assistance. The Face, Arm, Speech, Time (FAST) and Balance, Eyes, Face, Arm, Speech, Time (BE FAST) are commonly used stroke symptom messages shown to improve stroke symptom recognition and response. However, cultural factors and language differences may limit the effectiveness of stroke symptom messages and their acceptability in different countries and contexts. There has not been a comprehensive examination of the stroke symptom messages used worldwide and how these messages have been adapted in various settings.
We explored what stroke response messages are being used globally, and the contextual factors that influence the adoption of a stroke response mnemonic in different settings.
A 14-item survey was disseminated by the World Stroke Organization to its networks. The survey contained open- and closed-ended questions and allowed uploading relevant stroke symptom campaign materials. The survey was analyzed using descriptive statistics and a content analysis.
All except one survey respondent used a stroke symptom message. Fifteen respondents (27%) reported they did not translate their stroke awareness messaging. Of these 15 respondents, they used the English versions of FAST (n = 8), BE FAST (n = 4), and both FAST and BE FAST (n = 3). Forty respondents (71%) reported that they/their organization used an acronym to raise public awareness of the signs/symptoms of stroke that was different from FAST or BE FAST (English), many of which were direct or indirect translations or influenced by FAST and BE FAST. Survey responses shared insights and recommendations related to the content, tailoring and dissemination of stroke symptom messages.
Study findings highlight the global use of stroke symptom messages and their contextual adaptations to fit diverse settings and contexts. The challenges in applying universal or commonly used stroke symptom messages to different contexts were highlighted.
Nurses could have a key role in raising awareness of stroke symptoms and the development of locally adapted stroke symptom messages.
Assess US registered nurse genomic competency.
Administered the Genetics and Genomics Nursing Practice Survey (GGNPS).
GGNPS assesses genomic knowledge, skills, attitudes, confidence, and utilization in nursing practice. Distributed by the American Nurses Association via email and online to US registered nurses. Results are analyzed using descriptive statistics and compared to 2010 data.
1065 registered nurses responded. Most (41%) were Master's prepared, actively seeing patients (51%) and 66% considered it very important to learn more about genomics. Most (55%) reported their genomic knowledge was poor yet 51% reported a patient initiated a genetic discussion with them in the past 3 months. 66% completed all knowledge score items with a median score of 9/12, no change from 2010. Only 26% had heard of the Essential Competencies. Most reported no genomic curricular content (64%); had not attended a genomic course since licensure (64%); intended to learn more about genomics (70%); and would attend a course on their own time (79%).
Nurses felt genomics was important but have capacity deficits. Despite genomic discoveries and evidence-based practice guidelines that impact healthcare quality and safety, 20 years after the Genomic Competencies were established (2005) nursing genomic practice capacity remains low.
Genomics is critical to the safe, quality nursing practice regardless of the level of academic training, clinical role, or specialty.
Randomized controlled trials (RCTs) are essential for evidence-based nursing care. However, the quality of reporting and adherence to methodological standards in Latin American nursing journals remains unclear. This study evaluates the characteristics, reporting quality, and potential risk of bias of RCTs published in Latin American nursing journals.
To assess the reporting compliance and risk of bias of RCTs published in Latin American nursing journals.
Meta-research study.
A comprehensive handsearch of 29 Latin American nursing journals was performed covering publications from 2000 to 2024. Identified RCTs were assessed for adherence to CONSORT reporting guidelines and evaluated for risk of bias. Outcomes were classified using the COMET taxonomy. A descriptive analysis was performed.
A total of 6377 references were screened, identifying 34 eligible RCTs, most published after 2018. The median CONSORT compliance was 19 reported items (IQR 16–22). High compliance (> 90%) was observed in abstract reporting items, study objectives, and participant selection criteria. However, critical methodological features such as randomization procedures, blinding, and protocol registration showed low adherence (< 40%). Risk of bias was mostly rated as having “some concerns”, largely due to insufficient reporting. According to the COMET taxonomy, the most frequently reported outcome domains were “Delivery of care” and “Physical functioning”.
Reporting compliance and risk of bias of RCTs published in Latin American nursing journals presents significant gaps, particularly in key methodological domains. These shortcomings hinder transparency, reproducibility, and integration into evidence synthesis. Strengthening editorial policies and enforcing reporting standards could enhance the quality and reliability of published research in Latin American nursing journals.
To identify the barriers and facilitators in the implementation of fertility preservation (FP) shared decision-making (SDM) in oncology care.
Qualitative descriptive study.
Qualitative interviews with 16 female patients with cancer and seven healthcare providers were conducted between July 2022 and April 2024. Data were analyzed using directed content analysis, guided by the implementation science framework.
We identified 22 categories comprising 38 codes as barriers to SDM implementation and 17 categories comprising 26 codes as facilitators. Findings revealed that, at the innovation level, accessibility, feasibility, interdisciplinary collaboration, and quality improvement efforts were decisive in the implementation of FP SDM. At the individual level, healthcare providers' awareness and attitudes towards FP and SDM, as well as patients' knowledge, attitudes, and capabilities in FP SDM, were crucial factors in the implementation of FP SDM. In social, economic, and organizational contexts, support from significant others, social awareness about FP, multidisciplinary care, financial assistance, and educational resources were determinants in implementing FP SDM.
Implementing FP SDM among female patients with cancer necessitates a strategic approach that considers barriers and facilitators. Educating and promoting FP SDM among the public and healthcare providers, combined with incentivizing policies, can enhance individual knowledge and awareness while achieving systemic improvements, facilitating its successful implementation.
This study provides insights into barriers and facilitators and proposes strategic approaches to enhancing FP SDM implementation, contributing to improved quality of life for cancer survivors and advancements in clinical practice.
The climate crisis impacts global health and is exacerbated by the healthcare sector's emissions. Nurses, as the largest professional group, are key to promoting climate-resilient, low-carbon health systems. Integrating climate change and sustainable development into nursing education is crucial, yet gaps remain in understanding their representation in curricula and practice. This review examines the role of nursing in addressing climate change and sustainable development, focusing on their integration into education and related recommendations.
A narrative literature review was conducted to synthesize existing recent research on nursing, climate change, and sustainable development. No restrictions were applied to study design; however, studies published before 2017 were excluded.
A search was conducted in PubMed, CINAHL, and Google Scholar (January 2023, and updated in August 2024). Relevant studies were screened and duplicates removed. Data extraction followed inductive content analysis, with coding and categorization being undertaken collaboratively. MAXQDA PLUS 2022 was used for analysis, and new findings from the follow-up search were incorporated into existing categories or new ones were developed.
The review analyzed 33 articles on nursing's role in addressing climate change. Findings highlight gaps in knowledge, delayed responses, and the need for nurses to take on leadership roles. Education is crucial, yet curricula integration remains limited. Nurses must engage in advocacy, interdisciplinary collaboration, and policy development. Barriers include a lack of faculty awareness and overloaded curricula. A collective call for action urges nurses to embrace sustainability, strengthen research, and lead in achieving climate resilience.
This review highlights the need to integrate climate change and sustainable development into nursing education and practice. Nurses are vital to public health and to addressing climate change, but education gaps hinder their potential. Future research should focus on improving curricula, exploring Advanced Practice Nursing leadership roles, and addressing healthcare system challenges.
Integrating Sustainable Development and the Climate Crisis into nursing education and practice is crucial to preparing nurses for the health challenges posed by environmental changes, as well as for ensuring effective patient care, disaster response, and policy advocacy. Their integration is a process and should be viewed as being a consequence of the delayed responses, as identified in this review. This process should specifically address the identified gaps, such as the lack of basic knowledge concerning climate change and sustainable development, as well as learning to take on leadership roles in practice. More specifically, taking a leadership role includes both acting as a knowledge multiplier and increasing the health literacy of the general population.
Socially assistive robots (SARs) have been used in group interventions for older adults; however, their effectiveness remains unclear. This systematic review aimed to synthesize evidence on the efficacy of group interventions with SARs on various outcomes (physical, cognitive, psychological, quality of life, therapeutic engagement, and sociality) for older adults, and the factors that influence their effectiveness.
A literature search was conducted using five databases (Web of Science, PubMed, Scopus, PsycINFO, and MEDLINE) in October 2024. The research team selected and analyzed the studies applying a narrative synthesis.
In all, 25 articles were identified, 15 of which were deemed of good quality. We found that companion robots are commonly used in group interventions for older adults that consist of physical, cognitive, and combined physical and cognitive activities. Insufficient evidence was identified on the effectiveness of physical interventions and groups with physical and cognitive activities on health outcomes (i.e., physical, cognitive, psychological, and quality of life). Regarding the cognitive group interventions, positive physical outcomes (i.e., improved sleep quality, decreased pulse rate, and increased pulse oximetry), improved cognitive function, positive psychological outcomes (i.e., decreased agitation, depression, anxiety, and loneliness, and increased positive emotions) were found; however, the positive effects in terms of cognitive level and certain psychological outcomes were comparable to the control groups. Mixed results were reported for quality of life in older adults. Across the three types of interventions, robots facilitated engagement and increased the sociality of most older adults. The effectiveness depended on the cognitive function of the older adults, the presence of staff, the type of robot, and the schedule of the interventions.
Research gaps have been identified, and more rigorous studies investigating the effectiveness of different types of group interventions in older adults are needed before applying SARs in group interventions on a large scale.
Given the importance of group interventions in nursing care of older adults, healthcare professionals can use socially assistive robots in such interventions to assist in caring for older adults.
The way communication is conducted directly influences the professional–patient relationship, how patients cope with their diagnosis, and their sense of hope throughout treatment. This study aims to map the literature on strategies that healthcare professionals can use to promote hope in communication with pediatric patients and their families in the context of chronic illness. Based on this objective, the study highlights an algorithm to assist healthcare professionals in instilling hope in this population through communication.
Scoping review.
This systematized review was conducted using the databases PubMed, LILACS, PsycInfo, Embase, CINAHL, and Scopus, employing the PCC framework and the Boolean operators AND and OR. The time frame was limited to the last 20 years (2004–2024). A total of 734 studies were identified across the databases, with an additional four retrieved through manual citation searches, resulting in 19 articles included in the final sample.
The findings highlight three key pillars for promoting hope in communication: (1) careful preparation for information delivery, which involves identifying the diverse needs of families and creating a physically comfortable and emotionally supportive environment; (2) providing information and emphasizing how it is presented—considering content, clarity, honesty, empathy, and adaptation to the recipient's specific needs; and (3) follow-up after information delivery, ensuring emotional support and active, skilled listening.
Interpersonal communication between the healthcare professional, the patient, and the family was mainly focused on the transmission of information about the disease and treatment in a clear and empathetic manner, considering who is receiving the information and how the information is interpreted.
This review provides guidance for healthcare professionals in implementing communication strategies that foster hope in the context of pediatric chronic illness. Additionally, this guide may serve as a model for training students and healthcare professionals. Further research is needed to implement and explore additional effective communication strategies for this population across diverse cultural settings.
To explore the association between psychological capital and psychological distress in stroke patient–spouse dyads and examine the mediating effect of relationship satisfaction in this association.
A population of 207 stroke patient-spouse dyads completed the Positive Psychological Capital Questionnaire, Quality of Relationship Index, and Kessler Psychological Distress Scale. A dyadic analysis was conducted using the actor-partner interdependence mediation model.
In stroke-affected couples, a noteworthy interaction exists between moderately elevated levels of psychological capital (p < 0.01). Patients exhibit significantly diminished psychological capital and heightened psychological distress compared to their spouses (t = −5.429, p < 0.001; t = 2.536, p < 0.05). Conversely, there is no significant variance in relationship satisfaction between patients and the partners (t = −0.920, p > 0.05). Patient relationship satisfaction acts as a mediator in the correlation between dyadic psychological capital and patient psychological distress (β = −0.020, p < 0.05; β = −0.011, p < 0.05). Similarly, spousal relationship satisfaction serves as a mediator in the connection between dyadic psychological capital and spousal psychological distress (β = −0.011, p < 0.05; β = −0.020, p < 0.05).
Psychological distress was reduced when psychological capital or relationship satisfaction in stroke dyads was promoted, and relationship satisfaction is an important mediator of the impact of psychological capital on psychological distress in the dyads. Healthcare providers should pay equal attention to spouses and implement dyadic psychological capital interventions centered on stroke couples to enhance relationship satisfaction and reduce psychological distress.
Gender equity and workplace bias are critical factors influencing job satisfaction and career progression in healthcare. Despite global initiatives promoting equity, disparities persist within nursing, impacting organizational commitment and workforce retention.
This study investigates registered nurses' perceptions of gender equity and workplace bias and their impact on job satisfaction at King Khaled Hospital, Saudi Arabia.
A cross-sectional quantitative study design was employed, involving 246 randomly selected registered nurses. Data were collected using the gender equity in the Workplace Scale (GEWS), Workplace Gender Bias Scale (WGBS), and Job Satisfaction Survey (JSS). Descriptive statistics and Pearson correlation analyses were conducted using SPSS to assess gender differences and relationships between perceptions of equity, bias, and job satisfaction.
The study revealed moderate agreement regarding gender equity in promotions (48.8%) and compensation (52%), indicating room for improvement in implementing equality policies. Workplace bias was perceived notably in stereotyping (50.8%) and differential treatment (60%), with female nurses reporting higher levels of bias. Job satisfaction was moderate, with 60% of participants expressing overall satisfaction and only 42% satisfied with promotional opportunities. Perceptions of gender equity positively correlated with job satisfaction (r = 0.65, p < 0.001), while workplace bias was inversely correlated (r = −0.54, p < 0.001).
Persistent gender inequities and workplace biases negatively affect job satisfaction and career progression in nursing. Addressing these disparities through equitable organizational policies, diversity training, and inclusive leadership can enhance job satisfaction, improve retention, and foster a supportive work environment. These findings highlight the need for systemic reforms to promote workplace equity and well-being in healthcare organizations.
Falls among older adults are a major public health concern, often leading to serious outcomes such as fractures, head trauma, and increased mortality. Virtual reality (VR) interventions have emerged as a promising strategy for fall prevention by improving balance, reducing fear of falling, and enhancing confidence. However, the impact of VR interventions on specific outcomes such as fear of falling, balance, and postural control in older adults remains insufficiently synthesized.
Systematic review and meta-analysis.
A comprehensive systematic search of six databases was conducted from inception to January 20, 2025. Randomized controlled trials (RCTs) evaluating VR interventions targeting fear of falling, balance, and postural control in older adults were included. Methodological quality was assessed using the Cochrane risk-of-bias tool (RoB-2). Pooled standardized mean differences (SMDs) with 95% confidence intervals (CIs) were calculated using random-effects models for each outcome.
Seventeen RCTs involving 988 older adults, published between 2016 and 2025, met the inclusion criteria. VR interventions demonstrated significant effects in reducing fear of falling (SMD = −0.40; 95% CI: −0.72 to −0.08; I 2 = 45.10%; p = 0.02), improving balance (SMD = 0.45; 95% CI: 0.07–0.83; I 2 = 73.54%; p = 0.02), and enhancing postural control (SMD = 0.50; 95% CI: 0.13–0.86; I2 = 46.89%; p = 0.01).
This meta-analysis highlights the effectiveness of VR interventions in reducing fear of falling and improving balance and postural control among older adults.
VR represents a valuable tool in fall prevention strategies, addressing key outcomes essential for maintaining independence and mobility in this population.
Today in academia and health care, creating a vision and crafting a career path that progresses toward that vision is essential. Career cartography is the comprehensive and iterative process of applying the science of cartography within the context of policy toward achieving a career with impact.
The purpose of this article is to advance the knowledge and application of the original publication as described by Feetham and Doering in 2015. Career cartography supports scientific thinking, communicates science, and addresses the uncertainty of a career.
We conducted a critical analysis of differences between the original publication and our current practical experience of career cartography. Workshops conducted the past 10 years have advanced our understanding of the career cartography components and their utility to one's career. This analysis is informed by a review of the 25 publications citing the 2015 publication to evaluate how scholars report applying the process across health professions and organizations.
All components of career cartography are expanded beyond the 2015 publication to include application of the process with exemplars.
Career cartography is an effective guide across disciplines and at all stages of a career for determining, directing, evaluating, and communicating one's career and its impact.
The intentional and ongoing use of career cartography maximizes the impact one's chosen career can have on improvements to health and health policy.
Work flow is critical for nurses due to the demanding nature of their profession, as it enhances stress resilience, engagement, and quality of care.
This study sought to examine the relationship between perceived organizational support for strengths use and work-related flow among nurses, and to explore the mediating roles of psychological capital components: self-efficacy, resilience, hope, and optimism.
This cross-sectional study, involving 607 nurses, was conducted in March 2024. Validated scales were employed to measure perceived organizational support for strengths use, psychological capital, and work-related flow. Data analysis was performed using SPSS version 25.0, along with the PROCESS macro for mediation analysis.
The study revealed a significant positive relationship between perceived organizational support for strengths use, psychological capital, and work-related flow. Among the four psychological capital dimensions, only self-efficacy and optimism significantly mediated the relationship between perceived organizational support for strengths use and work-related flow.
These findings underscore the importance of fostering a strengths-based organizational climate and enhancing key psychological resources—particularly self-efficacy and optimism—to improve nurses' flow experiences at work.
Enhancing perceived organizational support for strengths use can foster self-efficacy and optimism among nurses, thereby promoting work-related flow. By cultivating a strengths-based work environment and reinforcing key psychological resources, healthcare institutions can improve nurses' well-being, engagement, and ultimately the quality of patient care.
Amid a global nurse staffing crisis, in 2019 Scotland legislated the Health and Care (Staffing) (Scotland) Act to address health care workforce challenges. Instead of requiring patient-to-nurse ratios as legislated elsewhere, this act requires staffing decisions according to guiding principles, duties, and a common staffing method. Measuring variation in hospitals' adherence to the act's provisions at baseline is important for policymakers to evaluate fulfillment of the act's requirements and goals. Results will inform policymakers about which provisions are achieved at baseline and which require support for employers to achieve. The purpose of the study was to establish the baseline of nurse staffing standards in Scotland at April 2024 implementation of the Act. Nurse reports of quality, safety, and their intent to leave were measured to complement assessment of the implementation status.
A cross-sectional study design was used. A convenience sample of registered nurses and nursing support workers was recruited through professional organizations and trade unions. Nurses were invited to complete an online survey between May 1 and July 31, 2024. The survey content included demographic and professional characteristics, international nursing metrics, the Act's provisions, and job intentions. Descriptive statistics were calculated to describe the sample, act's provisions, and nurses' job intentions.
The sample comprised 1870 nurses, of whom 93% were registered nurses, from all regions with characteristics reflecting the Scottish nursing workforce. Regarding the act's provisions, 9% reported that nursing staffing is appropriate to provide safe, high-quality care every shift. Similarly, few nurses reported that the quality of care was excellent (17%) or graded safety an A (10%). Most nurses disagreed that current staffing levels met the eight guiding principles. Most nurses reported that the common staffing method and duties regarding real-time staffing decisions were followed at best occasionally. Nearly half of nurses (45%) intend to stay in their current job over the next year. Among those intending to leave their current job, about half plan to leave the profession through retirement or another unspecified job change. The other half plan to seek another similar nursing job or promotion.
Few nurses report that the act's overarching goal is being met at the point of implementation. Although most nurses see nursing as a long-term career, workforce disruption is anticipated through routine turnover, promotion, or retirement, requiring workforce retention policies. Whether the act's complex provisions can be achieved and its goals fulfilled may not reverse the trend of exiting nurses. The complexity of the approach will be a challenge to achieving the objective of safe staffing. Therefore, this approach to achieving safe staffing may be too complex to be recommended widely. These remain urgent questions for Scottish policymakers, nurse leaders, and researchers.
Dementia notably increases fall risk in older adults, leading to major injuries and considerable concerns from health-care professionals. However, comprehensive evidence regarding the prevalence, incidence rate, and moderating factors of falls in institutional settings is limited. This study aimed to evaluate the prevalence, incidence rates, and moderating factors of falls among older adults with dementia in nursing homes and dementia-specialized care units.
A meta-analysis.
We searched CINAHL, PubMed, Embase, ProQuest, Scopus, Web of Science, and PsycINFO from database inception to April 30, 2024. Older adults with dementia in nursing homes or dementia-specialized care units were included. The pooled prevalence was analyzed using a generalized linear mixed model with random effects using R software. Incidence rates were reported per person-year using comprehensive meta-analysis software. Study quality was assessed using Hoy's criteria. Variations in the pooled prevalence of falls were explored through moderator analyses.
This meta-analysis included 21 studies involving 35,449 participants. The pooled prevalence of falls was 45.6%, with subtypes showing 39.2%, 35.2%, and 29.0% among Alzheimer's dementia, vascular dementia, and mixed dementia subtypes, respectively. Falls were more prevalent in dementia-specialized care units (53.0%) than in nursing homes (42.6%). The overall incidence rate was 3.61 per person-year, higher in dementia-specialized care units (5.80) than in nursing homes (3.17). Subgroup analyses revealed higher fall prevalence in women (70.0%) than in men (30.6%). Meta-regression indicated that comorbidities, including delirium, visual impairment, and arthritis, increased fall risk.
This meta-analysis revealed a high incidence of falls in nearly half of older adults with dementia, particularly among those in dementia specialized care units.
Healthcare professionals should prioritize regular fall risk assessments, tailored interventions, and environmental safety modifications, particularly in dementia-specialized care units, to reduce fall-related injuries and improve patient outcomes.
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