Fulltext search in archive

Aim: To evaluated the effectiveness of the Australasian Triage Scale (ATS) in Croatian emergency departments by analyzing hospitalization, mortality, and discharge rates across different triage categories. Design: A retrospective cohort study. Methods: A total of 68,165 adult patients treated in the emergency department of the Clinical Hospital Center, Rijeka between January 1 and December 31, 2023. Patients were triaged into Australasian Triage Scale levels 1 to 5, and their outcomes – including hospital admissions, discharges, and mortality – were analyzed. Statistical significance was assessed using chi-square tests for categorical variables, with Bonferroni-adjusted post-hoc pairwise comparisons. Age differences across categories were analyzed using ANOVA and Kruskal-Wallis tests. A p-value of < 0.05 was considered statistically significant. Results: Significant differences in outcomes were observed across all Australasian Triage Scale categories (p < 0.001). Category 1 patients had the highest mortality rate (74.6%) and the lowest hospitalization rate (4.6%), reflecting the critical nature of these cases. Category 2 showed a mortality rate of 17.7% and a hospitalization rate of 26.3%. Category 3, which accounted for 45% of the sample, had the highest hospitalization rate (48.4%) with a lower mortality rate (6.9%), indicating appropriate triage of serious but non-immediately life-threatening cases. Categories 4 and 5 exhibited low mortality (0.8% and 0%) and high discharge rates (88.6% and 89.9%), supporting the accurate identification of lower-acuity patients. Post-hoc comparisons confirmed significant differences in hospitalization and mortality between most Australasian Triage Scale levels (p < 0.001), except between categories 4 and 5, in which no statistically significant difference was found (p = 0.169). Median time to treatment corresponded to clinical urgency, ranging from 0 minutes in ATS 1 to 24 minutes in ATS 5, indicating timely initiation of care. Conclusion: The Australasian Triage Scale effectively stratifies patients based on clinical urgency, facilitating appropriate resource allocation and timely intervention. However, the high proportion of non-urgent visits contributes to emergency department overcrowding. These findings underscore the need for public education on appropriate use of emergency departments and stronger integration of primary healthcare services to enhance triage efficiency.

Aim: Emotional intelligence (EI) is increasingly recognized as an essential competency in nursing leadership. This study explores how EI shapes the fundamental components of nursing leadership and its impact on healthcare outcomes. Design: The study is classified as qualitative research. Methods: A comprehensive literature review was performed using databases including EBSCO, Google Scholar, OVID, and Web of Science. Studies published in English between 2017 and 2022 were screened against predefined inclusion criteria. Thirty-three peer-reviewed articles were selected and subjected to contextual and thematic analysis. This qualitative approach allowed synthesis of recurring themes and insights into the influence of EI on nursing leadership and practice. Results: Emotional intelligence significantly impacts nursing leadership by improving patient outcomes, fostering teamwork, enhancing communication, and supporting quality care. Nurses with high EI nurses exhibit empathy, resilience, and positivity, contributing to stronger team dynamics, reduced turnover, and increased cohesion. Leaders with elevated EI levels earn trust, build respectful relationships, and inspire commitment. Moreover, EI reduces burnout, enhances job satisfaction, and ensures consistent quality control in nursing management. Conclusion: Emotional intelligence is fundamental to effective nursing leadership and has a positive impact on staff retention, satisfaction, and quality of care. Incorporating EI training into nursing education and recruitment is vital for sustaining nursing leadership excellence and optimizing healthcare outcomes.

Aim: To gain a deeper understanding of undergraduate nursing students’ perspectives on simulation-based learning (SBL) conducted after clinical placements, with attention to perceived benefits, learning experiences, and suggested improvements. Design: An exploratory qualitative approach was employed. Following an SBL experience, an analysis of students’ written reflections was conducted. Methods: Written reflections of 146 second-year nursing students were analyzed after they had participated in high-fidelity simulations followed by a structured debriefing. The students’ responses were examined using conventional content analysis. Results: Three themes emerged: perceived benefits, experiential aspects, and suggestions for improvement. Students reported improved self-confidence, teamwork, communication, and critical thinking skills. They appreciated the link between theory and practice, as well as the opportunity to practice rare but essential cases. As the scenarios progressed, their emotions shifted from anxiety to confidence, emphasizing the role of debriefing in reflection and learning. Students suggested allocating more time to simulations, diversifying the scenarios, and partially replacing clinical placements with SBL. Conclusion: Post-clinical simulations provide an effective bridge between theory and practice, enhancing students’ technical, non-technical, and reflective skills, while elevating their professional preparedness. Strategic integration of SBL before and after clinical placement could strengthen curricula, ensure exposure to essential clinical scenarios, and enhance patient safety.

Aim: Postpartum sexual dysfunction is common yet understudied, and the factors that contribute to it remain unclear. This study aimed to identify the determinants of sexual function among women in Greece during the first twelve months after childbirth. Design: A cross-sectional study. Methods: A cross-sectional online survey was conducted among 441 Greek-speaking women. The participants completed a structured questionnaire on sexual function, as well as associated demographic, physical, and psychosocial factors. Results: Higher maternal age, shorter sleep duration, limited family support, exclusive breastfeeding, and flatus incontinence were negatively associated with sexual function. In contrast, greater frequency of sexual intercourse before and during pregnancy, as well as a longer time elapsed since childbirth, were positively associated with sexual function. No significant associations were found with perineal trauma, mode of delivery, parity, high body mass index, or smoking. Conclusion: Prenatal parenting programs should incorporate counseling on maintaining sexual activity during and after pregnancy, provide information on breastfeeding, promote pelvic floor exercises, and emphasize the importance of family support. These factors were identified as key to improving maternal sexual health postpartum.

Aim: A longitudinal study aimed at evaluating the influences of age, body mass index, percentage of body fat, mobility and Type 2 diabetes mellitus on the development and progression of pressure ulcers in hospitalized overweight and obese patients older than 65 years. Design: A longitudinal cohort study. Methods: The study involved 86 men and 64 women. Patients were examined in three phases: upon admission to hospital, upon discharge, and 10–12 weeks after hospitalization. In each phase of the survey, the patients underwent anthropometry, and the occurrence and stage of pressure ulcers, mobility and the presence of diabetes mellitus were evaluated. Results: In phase 1 of measurement, there were 39.33% overweight patients and 60.67% obese patients; in phase 3, there were 34.67% overweight patients and 65.33% obese patients. The prevalence of pressure ulcers was 36.7%. Immobility was the strongest predictor of pressure ulcer development. Age significantly increased the risk of pressure ulcer development, especially in women. The presence of diabetes was not connected with a higher occurrence of pressure ulcers, but diabetics had more severe stages of pressure ulcers. The body mass index, percentage of body fat, and length of hospitalization were not significant predictors. Conclusion: Limited mobility and higher age are key risk factors for the formation of pressure ulcers in overweight and obese older adults. Diabetes mellitus does not influence the frequency of formation but is associated with progression and worse healing of pressure ulcers. Preventive care should emphasize mobilization and an individualized approach to repositioning at-risk patients.

Aim: To assess Portuguese nurses’ crisis resource management competencies in simulated emergency scenarios. Design: Quantitative, descriptive-correlational, and cross-sectional study. Methods: Data were collected between January and June 2024 using a paper-based questionnaire that included items on socio-professional characteristics and a translated version of the Ottawa Global Rating Scale for Crisis Resource Management. The unidimensional scale demonstrated high internal consistency, with a Cronbach’s alpha of 0.92. Participants were recruited through non-probability convenience sampling. Data were analyzed using IBM SPSS Statistics, version 28. Results: A total of 69 valid assessments were obtained using the Portuguese version of the Ottawa Global Rating Scale. Overall, 71.0% of participants demonstrated standard-level performance, while 27.5% achieved superior performance. The dimension in which exceptional competence was least frequently observed was Leadership (21.7%), whereas the highest proportion of exceptional competence was found in Resource Utilization (34.8%). Conclusion: This study enabled the assessment of nurses’ crisis resource management competencies within simulated emergency scenarios. Given the critical role of non-technical skills in ensuring patient safety, there is an urgent need to develop strategies that strengthen nurses’ leadership capabilities.

Aim: The study aimed to assess nurses’ knowledge and experience of health literacy using the Slovak 14-item HLKES-2 (Health Literacy Knowledge and Experience Survey 2) and explore its links with selected variables. Design: Quantitative, cross-sectional study. Methods: The sample consisted of 255 Slovak nurses. The data were analyzed using basic statistical methods (Mann–Whitney U test and Spearman’s correlation) and we evaluated the psychometric properties of the tool. Results: The results indicated low levels of health literacy knowledge (39.65%; 4.43 ± 2.58) and moderate levels of experience with health literacy (5.05 ± 2.58). Nurses’ knowledge was not related to their education, workplace, or prior training in health literacy (p > 0.05). Nurses working in general wards reported higher levels of health literacy experience compared to those in intensive care units (p = 0.018). The analysis showed low reliability for the ten multiple-choice knowledge items and good reliability for the four Likert-type experience items. Conclusion: The findings indicate that nurses demonstrated substantial practical experience but possessed limited knowledge of health literacy. These results underscore the need to strengthen education in this area to enhance patient communication.

Aim: To compare digital health competence (DHC) and associated factors among Czech nurses from various healthcare settings, using online versus paper-based data collection methods. Design: A cross-sectional survey. Methods: Data were collected from October 2023 to July 2024. The survey included demographic and professional data, along with two DHC instruments: DigiHealthCom and DigiComInf, translated from English to Czech. Descriptive analysis, likelihood ratio (LR), χ² and Fisher’s exact tests, and the Mann-Whitney U test were used to analyze the data. Results: The survey was fully completed by 263 nurses. Significant differences were observed between the paper-based and online subgroups in most demographic and professional variables, with large effect sizes for educational level (Z = -7.436; p < 0.001) and frequency of patient interactions (Z = -6.243; p < 0.001). Overall, most DHC items received favorable ratings for digitalization and associated factors. While subjectively perceived DHC differed significantly between the subgroups in most factors, the effect sizes of these differences were not large. Conclusion: Although the level of DHC was favorable, further research is warranted due to extensive missing data, which may be the result of limited experience and a lack of established opinions on certain items.

Aim: Nurses in intensive care units are confronted with a multitude of alarms and noises every day, which can lead to alarm fatigue. Various interventions have already been investigated to reduce or prevent this. The aim of this review is to provide an overview of empirically investigated interventions to counteract alarm fatigue in critical care nurses. Design: A scoping review. Methods: We conducted a scoping review and carried out literature searches in Medline, Cochrane Library, and CINAHL. In addition, we performed manual searches in LIVIVO and Google Scholar, as well as citation searching. We included studies on interventions aimed at reducing existing alarm fatigue or preventing potential alarm fatigue among nurses working in intensive care units. Following title, abstract, and full-text screening, data were extracted and synthesized using an inductive approach. Results: Seventeen studies met the inclusion criteria. The included studies were categorized into six clusters: “process interventions” (n = 8), “technological interventions” (n = 7), “training courses” (n = 7), “alarm individualization” (n = 11), “memory aids” (n = 6), and “intervention bundles” (n = 11). The investigated outcomes were divided into alarm fatigue (n = 8) and etiological factors of alarm fatigue (n = 9). Conclusion: Current studies on interventions against alarm fatigue are heterogeneous and difficult to compare. Future research should rely on controlled experimental designs to ensure comparability between studies.

Aim: The present research aimed to provide a systematic analysis of the work ability (WA) of nurses assessed through the Work Ability Index (WAI) with a focus on factors influencing WA in the studied population. Design: A systematic literature review. Methods: In January 2024, a literature search was performed using Medline / PubMed and ScienceDirect databases, in order to identify studies focused on assessment of WA with the WAI among nurses. Databases were searched using ‘work ability index’ and ‘nurse’ as key terms. Articles were selected according to PRISMA guidelines. Results: Three hundred twenty-two studies were identified in the initial search (230 studies indexed by Medline / PubMed and 92 by ScienceDirect). After applying inclusion and exclusion criteria, a total of 16 studies were included in the systematic review. The results revealed common factors that affect WA among nurses. These factors are grouped as follows: age, gender, marital status, education, years of work, shift work, and diagnosed diseases. Conclusion: Assessing the WA of nurses with the WAI provides a comprehensive and structured approach to understanding their capacity to meet the demands of their profession while considering various dimensions of health and work-related factors.

Aim: We aimed to determine the incidence of and risk factors for shoulder dystocia in Greek tertiary maternity settings. Design: A retrospective case-control study. Methods: Study of women who gave birth at the University Hospital of Larissa in Greece between 2019 and 2024. We matched every case of women with shoulder dystocia with ten women giving birth without shoulder dystocia. We compared the maternal demographics and the perinatal outcome between cases and controls. Results: A total of 1,536 vaginal births were identified over the study period. There were 21 documented cases of shoulder dystocia (1.4% incidence rate) matched with 210 uncomplicated vaginal births. The median age of women with shoulder dystocia was 28 years (IQR = 25–31), 42.9% were nulliparous, and the median gestational age was 39+2 weeks. There was no postpartum hemorrhage, and perineal trauma was comparable between women with and without shoulder dystocia. No neonates with shoulder dystocia were admitted to the neonatal unit and there were no stillbirths. More than 70% of cases with shoulder dystocia occurred during the afternoon and evening hours. The percentage of male neonates was significantly higher in cases with shoulder dystocia (76.2% vs. 51%; p = 0.02). The only independent predictor for shoulder dystocia was birthweight (OR = 1.24; 95% CI, 1.09–1.40). Conclusion: The incidence of shoulder dystocia and perinatal outcomes are in line with the literature. These local data reflect an efficient maternity service provision and can be used as a benchmark for future comparisons and evaluation, since there is no other similar study within Greek clinical settings that reports on shoulder dystocia.

Aim: The study aimed to examine how socio-demographic factors, age, nursing specialty, and the frequency of end-of-life care provision influence nurses’ attitudes toward death and fear of death. Design: A cross-sectional quantitative study. Methods: Data analysis was conducted on a sample of 250 nurses. Attitudes toward death were measured with the Death Attitude Profile-Revised (DAP-R) and the Multidimensional Fear of Death Scale (MFODS). Statistical analyses were performed using SPSS 23.0, applying descriptive statistics, the Shapiro-Wilk test, the Mann-Whitney U test, the Kruskal-Wallis test, Spearman’s rank correlation, and linear regression analysis. Results: No significant differences in fear of death were found between young (18–40 years) and middle-aged (41–65 years) nurses (DAP-R: p = 0.89; MFODS: p = 0.18). No significant correlations with age were observed (DAP-R: ρ = -0.004; p = 0.95; MFODS: ρ = 0.11; p = 0.09). The frequency of end-of-life care provision correlated significantly with fear of death on the DAP-R (ρ = 0.19; p = 0.003) and was negatively correlated with the MFODS (ρ = -0.15; p = 0.02). Conclusion: Fear of death showed no significant differences across age groups or clinical settings, except in relation to the frequency of exposure to dying patients.

Aim: The aim is to determine how fully the needs of patients with cancer and those of patients with advanced chronic disease are met in palliative care and how needs differ in importance between the two groups. Design: A cross-sectional study. Methods: The study population consisted of patients with advanced chronic disease and cancer patients admitted either to cancer wards or a hospice. The study period was from January 2023 to May 2023. A valid and reliable tool, the Patients’ Needs Assessment in Palliative Care, was used to assess the needs of patients. The total number of respondents was 126. Results: Physical needs are most important to patients with advanced chronic illness. Autonomy needs are most important to cancer patients. For patients with advanced chronic illness, the highest level of needs fulfilment was in the area of social needs. The highest rate of fulfilment for cancer patients was in the area of social needs. Conclusion: Needs assessment of patients in palliative care is essential since it allows healthcare professionals to better understand the individual needs of patients in their final phase of life.

Aim: To explore the clinical learning environment (CLES), the role of the teacher (Tc2), and learning in a clinical practicum (LCP), and to explain the associated educational factors from healthcare students’ perspectives. Design: A quantitative cross-sectional study. Methods: An online survey comprising CLES, Tc2 and LCP scales, each of which was measured using a 10-point Likert scale, was used to collect data from 1133 healthcare students at the end of their clinical practicum in a university hospital district in Finland. The data were analyzed statistically using one-way ANOVA, Spearman correlation coefficients, and linear models. Results: Students rated CLES (median 9.23) and LCP (median 9.13) the highest, and Tc2 (median 7.64) the lowest. Moderate positive correlations were found between CLES and Tc2 (r_s = 0.438, p < 0.0001), as well as between CLES and LCP (r_s = 0.625, p < 0.0001). The strongest positive correlation was found between the premises of learning and LCP. Additionally, significant positive associations were found between several educational factors and CLES, Tc2, and LCP. Conclusion: The role of the teacher should be further explored to meet the expectations of healthcare students and better support their clinical learning. More objective measurements are needed to focus on the students’ achievement of intended learning outcomes that facilitate their transition from students to professionals.

Aim: The aim of this integrative literature review was to identify and synthetize empowering educational actions (EEA) that can be taken by nurses to support the empowerment of patients with long-term health problems. Design: An integrative literature review. Methods: The review followed methodology by Whittemore and Knafl. Four databases (PubMed, Web of Science, CINAHL, Scopus) were searched between January 2000 and October 2023 for relevant studies published in English. After complimentary manual searches, the quality of the included studies (n = 9) was assessed independently by two researchers using a tool by Hawker et al. Data were analyzed using inductive content analysis. Results: Three main categories of nurses’ actions were synthetized: supporting patients’ knowledge and skills, supporting patients’ well-being, and supporting trust-based relationships and collaboration. Conclusion: Empowering patient education (EPE) is essential in supporting patients with long-term health problems to manage their own health. Nurses use varied empowering educational actions as part of EPE. The review’s results can be used to increase awareness and understanding of actions nurses can take to support empowerment of patients with long-term health problems as part of patient education both in clinical practice and nursing education.

Aim: The aim of this study was to compare the emotional competence of students in nursing and other, non-health, programs; to examine differences regarding age, gender, and work experience; and to propose reforms to the nursing education curricula concerning the topics of emotional competence, regulation, and mental health. Design: A descriptive cross-sectional study. Methods: 105 respondents participated in the study. The Emotional Skill Competencies Questionnaire – 45 (ESCQ-45) was used. Data were analyzed in the SPSS 21.0 statistical program through confirmatory factor analysis with internal consistency reliability (α = 0.865). Results: The study showed statistically significant differences in emotional competence between nursing students and students of non-health programs, especially for the factors Perceiving and Understanding Emotions (p = 0.011) and Expressing and Naming Emotions (p = 0.032), and the total score on the survey (p = 0.009). No significant correlation was found between emotional competence and age, gender, or work experience. Conclusion: Although emotional competence tends to be more pronounced in nurses, it is necessary to develop it further and include it in teaching programs in order to improve the quality of nursing care and professional well-being.

Aim: The study aimed to assess the connection of psychological resilience, pain self-efficacy and quality of life in people with chronic kidney disease (CKD) on hemodialysis. Design: A cross-sectional study design was chosen. Methods: Data were collected from 361 adults receiving hemodialysis in hospital and private settings in a Southern European country over six months. This was done in a semi-structured interview using the Connor-Davidson Resilience Scale (CD-RISC), the Pain Self-Efficacy Questionnaire (PSEQ), and the Kidney Disease Quality of Life (KDQOL-36) questionnaire. Results: The results indicated that the higher the resilience, the higher the pain self-efficacy. In addition, pain self-efficacy was found to have a positive effect on minimising both the symptoms and burden of the disease, leading to better quality of life. Conclusion: The present study showed that the level of resilience was proportional to pain self-efficacy with limited effect of demographic parameters. In addition, both resilience and pain self-efficacy affected health-related quality of life in people on hemodialysis. Using up-to-date assessment tools and implementing appropriate pharmacological and non-pharmacological interventions in everyday clinical practice can improve the quality of life of people on hemodialysis.

Aim: Empathy is a vital component of medical and nursing practice. However, research on empathy erosion among healthcare students has produced mixed findings, potentially due to measurement-related limitations. This study is the first to examine empathy erosion among Slovak medical students within the framework of trait emotional intelligence (TEI). Design: Quantitative, correlational-comparative, cross-sectional study. Methods: Data were collected from 545 medical students across all six years of study (57% women; M_age = 22.3, SD_age = 2.1) via an online questionnaire assessing empathy (Empathy Quotient; EQ) and trait emotional intelligence (TEIQue–SF). ANOVA was used to compare empathy and TEI across study years, followed by correlational and linear regression analyses to explore the relationships between empathy and TEI. Results: No significant differences in empathy or TEI were observed across study years. Female students scored higher in empathy. TEI and its factors were significant predictors of EQ, explaining 14% and 36% of the variance in empathy scores, respectively. Conclusion: The findings indicate that empathy, TEI, and its factors do not vary significantly across the demanding years of medical training. These results highlight the importance of careful selection of measurement tools when assessing psychological constructs.

Aim: The aim of this study was to evaluate mothers’ breastfeeding self-efficacy (maternal confidence) in association with demographic and clinical characteristics. Design: An observational longitudinal study. Methods: Data were collected with the Breastfeeding Self-Efficacy Scale – Short Form (BSES-SF) questionnaire from 102 breastfeeding women three days after delivery in three hospitals, and at the third and sixth weeks at home. Results: Parity was a key finding in the overall assessment of breastfeeding self-efficacy, with multiparous women demonstrating higher breastfeeding self-efficacy than primiparous women at all three time points (day three: p < 0.001; week three: p = 0.015; week six: p = 0.037). Strong correlations were found between all paired time points (p < 0.001). Analysis of individual questions revealed differences primarily related to parity, while other demographic and clinical characteristics showed only occasional significant differences. In terms of time, it was found that women need most support in the first three weeks after birth. Conclusion: The results of this study provide evidence-based guidance for healthcare professionals on how to offer effective, individualized support to women in initiating and continuing breastfeeding, both in clinical settings and at home, as well as on how to ensure accurate communication between both parties to help achieve this goal.

Aim: The main objective was to determine how hospitalized patients subjectively perceive sleep disturbances. The study also assessed the influence of selected factors (physiological, physical, environmental, and psychological) and clinical and demographic variables on sleep disruption. Design: A multicenter descriptive study. Methods: Conducted in seven Czech hospitals from February to May 2023, the study included 397 patients in general wards. Data were collected using a modified questionnaire on sleep disturbances, and the results were analyzed using non-parametric statistical tests. Results: The sample comprised 193 males (48.6 %) and 204 females (51.4%). Females reported more sleep disturbances than males (p = 0.023). Psychological and physical factors had a greater impact on females. Younger patients reported poorer sleep quality (p = 0.015). Pain was the strongest clinical factor that negatively affected sleep (Ra = 0.730). Environmental factors were the leading cause of sleep disturbance in patients (Ra = 0.836). The variability associated with all the factors studied (environmental, psychological, physiological, and physical) accounted for 97.6% of the total variability in sleep disturbance. Conclusion: Females and younger patients experienced more sleep disturbance. Pain and environmental factors were the primary causes of disrupted sleep. Differences were noted in the factors affecting sleep between genders.

Aim: Exploration of counseling contents and the role of nurse navigators (NN) in maternity clinics to support parents (and parents-to-be). Design: A retrospective descriptive study. Methods: A content analysis along with the development of initial categories of selected characteristics was conducted based on the written documentation of NN conversations from the pilot phase, covering the period from January 2021 to December 2023 (36 months). Results: A total of n = 757 conversations with pregnant women and parents (and parents-to-be) were documented, and n = 707 were included. Consultations occurred in person (65.6%), by phone (27.4%), or both (6.9%). A total of 82.9% of parents and (parents-to-be) reported stressors, which were addressed individually. Key focus areas included health-related topics, referrals for postpartum midwives, contact with authorities and health insurance providers, and ensuring pediatric follow-up care. Conclusion: Introducing an Nurse Navigator Program (NNP) in hospitals creates opportunities but also challenges that require dialogue. Clear role delineation and collaboration with breast-care nursing and midwifery services are crucial for effective maternity care cooperation.

Aim: To evaluate the effectiveness of selected existential therapies, including Dignity Therapy (DT), Meaning-Centered Psychotherapy (MCP), Logotherapy, and Reminiscence Therapy (RT), in reducing death anxiety among adults with advanced cancer. Design: A systematic review and meta-analysis of randomized controlled trials (RCTs). Methods: A comprehensive search of PubMed, ProQuest, and EBSCO databases was conducted for RCTs published between 2018 and July 2025. Eligible studies included adult cancer patients receiving any of the four existential therapies. Data extraction and quality assessment were performed independently by two reviewers. Pooled effect sizes were calculated using a random-effects model, and subgroup analyses were conducted by therapeutic modality. Results: Nine RCTs involving 821 participants met the inclusion criteria. The pooled overall effect of existential therapies on death anxiety was small and not statistically significant. Subgroup analysis, however, demonstrated that dignity therapy significantly reduced death anxiety compared with control conditions. Other existential therapies showed modest but inconsistent effects. Conclusion: While existential therapies offer limited overall benefit for reducing death anxiety in advanced cancer, dignity therapy appears to be the most effective intervention. Further research employing comparative designs, more extended follow-up periods, and culturally adapted approaches is recommended to optimize psychosocial care for terminally ill patients.

Aim: The objective of this study was to examine healthcare professionals’ perceptions of patient safety culture in long-term care facilities in Slovakia. Design: A quantitative descriptive cross-sectional study. Methods: The research sample included 161 healthcare professionals from 12 long-term care facilities in Slovakia. Empirical data were collected from December 2023 to February 2024 using the Nursing Home Survey on Patient Safety Culture (NHSPSC). Results: Respondents rated the safety culture highest in the dimensions of Feedback and Communication About Incidents (72%) and Overall Perceptions of Resident Safety (69%) according to the NHSPSC. In contrast, the lowest ratings were for Staffing (36%), Nonpunitive Response to Mistakes (38%), and Compliance with Procedures (40%). Analysis revealed statistically significant associations between degree of patient safety, all dimensions of safety culture, and overall job satisfaction (p < 0.05). Patient safety ratings were influenced by the number of patients per shift and healthcare professionals’ intentions to leave their jobs. Conclusion: Patient safety culture significantly influences the level of safety experienced by patients residing in long-term care facilities in Slovakia. Assessment of this culture helps identify areas for improvement and raises awareness of safety among healthcare professionals.

Aim: To explore the effect of leadership and teamwork training when managing shoulder dystocia. Design: Randomized-controlled-trial. Methods: We randomized midwifery students attending a one-day workshop into groups A (intervention) and B (controls). Shoulder dystocia training and assessment was performed with a high-fidelity computerized birthing-simulator. The intervention involved a two-hour leadership and teamwork experiential learning module. All students participated in a pre-training assessment and theoretical and practical training and completed a post-training assessment. Group A students received the intervention following their theoretical and practical training, but prior to the final post-training assessment. Results: Fifty-one students participated (mean age 21.9 ± 3.1 years); 25 were randomly assigned to group A and 26 to group B. Before training, both groups showed similarly low baseline scores for successful deliveries, maneuver performance, confidence, communication, teamwork, and leadership skills. Students in both groups achieved similarly high post-training scores for successful deliveries (> 92%), maneuvers (> 16/20), and confidence (8/10). Compared with controls, participants receiving the intervention showed a trend toward higher teamwork (3.1 ± 2.4 vs 2.1 ± 2.1; p = 0.08) and leadership scores (3.8 ± 2.7 vs 2.6 ± 2.3; p = 0.08) at the end of the workshop. Conclusion: Our findings support the inclusion of a teamwork and leadership training module during shoulder dystocia simulation.

Aim: To analyze administration of patient education in nursing from the perspective of nurse administrators to provide new information and support for evidence-based practice and development. Design: A descriptive study. Methods: Data were collected through individual semi-structured interviews. The informants were nurse administrators (n = 6) working in primary health care in two large Finnish cities. The data were analyzed using inductive qualitative content analysis. Results: Two main categories were identified: administration of patient education and areas for improvement in the administration of patient education. Each category was further divided into four subcategories. Administration of patient education involves recognizing it as a distinct nursing action, ensuring nurses’ competence, supporting processes and resources, and fostering a value-based approach to patient education. Areas for improvement concern the identification, planning, implementation, and evaluation of patient education. Conclusion: At present, the administration of patient education in nursing appears to be unstructured and unsystematic. Moving forward, systematic administration and improvement of patient education will require a clear identification and delineation of the entire patient education process.

Aim: The aim of the paper was to determine students’ perceptions on whether they improve their knowledge and skills through their studies, to determine their attitude towards their chosen profession, and to investigate whether they are considering leaving Croatia. Design: A descriptive cross-sectional study. Methods: The instruments used in this study were a structured questionnaire of demographic data and a questionnaire constructed for the purposes of this research. In total 106 students from two study levels participated in the study. Statistical analysis showed frequencies and percentages, the arithmetic mean, and the standard deviation. Results: The results of the study showed that the majority of respondents (48.1%) believed that education contributed to the development of their profession, which is consistent with other studies. A slightly lower number of students (47.2%) believed that their education provided them with the necessary knowledge, while only a small number of students (7.5%) seriously considered leaving Croatia. Conclusion: Education is key to improving nursing care as it enables the delivery of quality healthcare, ensures a more effective response to patients’ needs, and contributes to the health of the community.

Aim: To explore the factors influencing COVID-19 vaccination uptake among nurses in Greece using the Health Belief Model (HBM). Design: A cross-sectional study. Methods: Data were collected using a structured questionnaire assessing demographic characteristics, professional responsibilities, and the HBM dimensions. A total of 450 nurses from general hospitals, pediatric hospitals, and nursing homes were considered eligible for the study. Results: Higher educational attainment (p = 0.03), positions of responsibility (p = 0.03), and belief in vaccine effectiveness (p < 0.001) were positively associated with vaccination. Older nurses (p < 0.001) and those with more years of service (p < 0.001) were more likely to be vaccinated. Nurses who had personal or professional exposure to severe COVID-19 cases were significantly more inclined to be vaccinated (p < 0.001). Regular influenza vaccination also correlated with COVID-19 vaccine uptake (p < 0.001). Barriers such as fear of side effects and distrust in vaccine safety were prevalent among nursing home staff, particularly those with lower educational levels. Conversely, general hospital nurses exhibited higher confidence in vaccine safety and efficacy, likely influenced by access to reliable information and direct exposure to COVID-19 cases. Conclusion: Findings underscore the importance of tailored interventions to address vaccine hesitancy, underlining education, trust-building, and the role of workplace policies.

Aim: To translate and cross-culturally adapt the instrument “Patient Observation Skills in Critical Care Nursing” into Norwegian. Design: A cross-sectional survey was conducted to assess the psychometric properties of the instrument and Norwegian critical care nurses (CCNs’) self-assessed patient-observation skills. Methods: Ninety-five Norwegian critical care nurses completed an electronic survey, and the results were statistically analyzed. Results: Exploratory factor analysis produced a seven-factor model with Cronbach alpha values ranging from 0.62 to 0.94, and the instrument’s content validity was high (S-CVI/Ave 0.96). The instrument “Patient Observation Skills in Critical Care Nursing” was successfully modified for the Norwegian context and showed outstanding psychometric qualities. Nurses rated their patient observation skills as excellent in respiratory, renal, and metabolic areas (which had the highest scores). Gastrointestinal and coagulation observations had the lowest scores. Conclusion: The instrument is valuable for nurse educators and managers as it provides knowledge to facilitate the development of nursing competence.