Royal College of Nursing

Background/Objectives: Gestational diabetes mellitus (GDM) affects approximately 12.7% of pregnant women in South Korea. While breastfeeding provides critical health benefits for mothers with GDM and their infants, including improved insulin resistance and reduced Type 2 diabetes risk, no validated GDM-specific breastfeeding knowledge instrument exists. This study aimed to develop and validate a breastfeeding knowledge instrument for women with GDM. Methods: This methodological study employed systematic procedures for the development and validation of knowledge test. Initial item generation yielded 30 items across three domains: postpartum physical characteristics, breastfeeding barriers, and breastfeeding benefits. Content validity was evaluated by six clinical experts and ten experiential experts (women with GDM). An online survey was conducted in October 2022 with 220 women diagnosed with GDM who were either pregnant or within six months postpartum. Item analysis, exploratory factor analysis, and reliability testing were performed. Convergent validity was assessed by calculating the Pearson correlation coefficient with an established breastfeeding knowledge scale. Results: Following expert review and psychometric analysis, the final instrument comprised 14 items across three factors: postpartum physical characteristics (3 items), breastfeeding barriers (2 items), and breastfeeding benefits (9 items). The Kaiser–Meyer–Olkin measure was 0.884, Bartlett’s test was significant (χ2 = 838.835, p < 0.001), and factor loadings were satisfactory. The KR-20 reliability coefficient was 0.826, and criterion validity was confirmed. Conclusions: This first validated GDM-specific breastfeeding knowledge instrument enables the identification of knowledge gaps and the development of targeted educational interventions to improve maternal-child health outcomes.

Background (General): The nursing process (NP) is a systematic framework for delivering holistic, evidence-based, and patient-centered care, yet its consistent application remains limited in many clinical contexts. Background (Specific): In Iraq, nurses face systemic, organizational, and cultural barriers that compromise the effective use of the NP, despite its foundational role in nursing practice. Knowledge Gap: While prior studies have identified individual challenges, few have comprehensively examined barriers using mixed-method approaches that integrate both quantitative and qualitative perspectives. Aim: This study sought to identify and analyze the barriers hindering the implementation of the NP among nurses in Mosul through a sequential mixed-method design. Results: Quantitative findings from 500 nurses revealed that lack of knowledge and skills (78.4%), insufficient organizational support (86.2%), and inadequate training (77.0%) were major barriers, while qualitative interviews highlighted themes of poor interprofessional communication, cultural resistance to change, and resource shortages. Novelty: By combining statistical analysis with thematic insights, this research offers a multidimensional understanding of NP challenges, emphasizing the interplay between personal competencies and systemic constraints. Implications: The findings underscore the urgent need for targeted interventions in training, policy, and organizational support to strengthen NP implementation and improve patient outcomes in resource-limited healthcare systems. Highlights : Lack of knowledge, training, and organizational support are the main barriers. Mixed-methods approach reveals both statistical trends and thematic insights. Urgent need for targeted interventions to improve nursing practice and patient outcomes. Keywords: Nursing Process, Barriers, Organizational Support, Training, Patient Care

ABSTRACTAimThis study explores the initial impact of the 2021 Military coup on Myanmar's nursing profession, clinical practice and clinical education.BackgroundMyanmar is a country historically riven by conflict; however, between 2010 and 2021, there was democratic reform and partial peace, prompting improvements in nursing practice and health outcomes. This study examines the impact of the 2021 coup, which effectively halted this progress, on Myanmar's nursing. It contributes to the limited literature exploring the effects of civil unrest and governmental coups on nursing, particularly in closed societies such as Myanmar.MethodsWe present a qualitative synthesis of semi‐structured interviews, undertaken with seventeen nurses in Myanmar via secure video link.ResultsNurses describe the challenges to nursing practice before the coup, the relative progress that Myanmar's nurses made in the short years of quasi‐civilian government and, following the coup, the significant deterioration in working locations, conditions and personal safety for nurses who refused to work in Junta‐controlled hospitals.DiscussionThe coup has damaged all aspects of nursing in Myanmar. These results document a rapid unravelling of progress, accentuated by long‐standing underlying weaknesses in systems and leadership, with additional threats to personal safety. This trend has been previously reported in other conflicts but rarely directly from nurses and never from Myanmar.Implications for nursingThe coup has been catastrophic for nursing in Myanmar. Participants describe widespread health system collapse, deliberate targeting by the junta and a need for international support.

Overweight and obesity are defined as abnormal or excessive fat accumulation that presents a risk to health. A body mass index (BMI) over 25 is considered overweight, and over 30 is obese. (Prevalence of obesity among young adults in developing countries ranges from 2.3 to 12%, with overweight as high as 28.8%. The present study is entitled to assess the determinants of obesity and knowledge on lifestyle modification strategies on obesity among nursing students in TMM College of Nursing college, Thiruvalla. A descriptive survey approach was used to conduct the study among 65 nursing students in TMM College of Nursing. A convenient sampling technique was used to select the sample. The data was collected by using a self-structured questionnaire and analyzed by descriptive statistics. Results: Out of 65 samples, most of the students preferred a mixed diet of which more than half of the students were normal, less than half of the students were overweight and a few obese. An increased number of students were not doing regular exercise. Most of them preferred to study by sitting while snacking and had academic stress. 1.53% of the sample had poor knowledge, 53.84% of the sample had average knowledge and 44.61% had above average. Conclusion: The study concluded that obesity and overweight is prevalent among nursing students. There are many determinants of obesity which need to be addressed.

Background: Premature birth remains a leading cause of neonatal morbidity and mortality globally. Parents of premature infants often face challenges in providing proper care after hospital discharge due to limited knowledge, inadequate caregiving skills, and a lack of readiness. Health education plays a vital role in improving parental competency and ensuring safe and effective home care. Objectives: This study aimed to evaluate the effect of health education on improving the knowledge, caregiving skills, and readiness of mothers in caring for premature infants. Methods: A quasi-experimental pre-posttest design was conducted involving 25 mothers whose premature infants were admitted to the neonatal unit of RSI Siti Hajar Sidoarjo. The intervention included structured health education using printed leaflets and direct nursing demonstrations. Data were collected through validated questionnaires and observation checklists before and after the intervention. Statistical analysis was conducted using the Chi-square test with a significance level of p < 0.05. Results: Before the intervention, 76% of mothers demonstrated poor knowledge, 100% lacked caregiving skills, and 100% were unprepared for home care. Post-intervention, 76% exhibited good knowledge, 80% showed adequate caregiving skills, and 84% were ready to care for their infants. All improvements were statistically significant (p = 0.000). Conclusion: Health education significantly improved maternal knowledge, caregiving skills, and readiness in caring for premature infants. It is recommended that structured educational programs be routinely integrated into neonatal discharge planning to support safe and effective home care.

Background: Financial stress is a growing concern among nursing students, particularly in low- and middle-income countries, where limited financial resources may affect students’ academic behavior. Academic integrity is fundamental to nursing education, directly influencing the development of ethical and competent healthcare professionals. Understanding the relationship between financial stress and academic integrity is essential for identifying factors that may compromise educational standards and future professional conduct.Aim: This study aimed to assess the association between financial stress and academic integrity among undergraduate nursing students in private colleges of Sargodha, Pakistan.Methods: A descriptive cross-sectional design was employed. The study was conducted in various private nursing colleges in Sargodha. Using the Raosoft sample size calculator and a total population of 450 students, a sample size of 270 was determined. Data were collected using a structured, self-administered questionnaire comprising demographic details, a validated Financial Stress Scale, and an Academic Integrity Questionnaire. Descriptive and inferential statistics, including chi-square tests, were applied using SPSS version 27. A p-value < 0.05 was considered statistically significant.Results: The findings showed that 54.8% of students experienced moderate financial stress, while 21.9% experienced high financial stress. Academic integrity was high among 44.8% of students, moderate in 38.1%, and low in 17.1%. A significant association was found between financial stress and academic integrity (χ² = 31.56, p < 0.001), with higher stress linked to lower integrity levels.Conclusion: Financial stress significantly influences academic integrity in nursing students. Targeted interventions to alleviate financial burdens may enhance ethical academic behavior.

Background: The 2014–2016 Ebola epidemic in West Africa exposed critical weaknesses in the primary health care (PHC) systems of affected countries, including Sierra Leone. In the aftermath, efforts have been made to rebuild and strengthen PHC structures. This study aimed to assess the level of community readiness and identify systemic gaps in PHC delivery across selected districts in Sierra Leone. Methods: A cross-sectional survey design was employed, collecting data from 380 community members across five districts using a structured questionnaire. Descriptive statistics, correlation analysis, and multiple regression were conducted to evaluate levels of community awareness, trust, participation, and systemic health service factors such as workforce availability and drug supply. Results: Findings revealed a high level of community awareness (M = 4.18, SD = 0.76) and moderate trust in local health authorities (M = 3.68, SD = 0.91), indicating improved public engagement with PHC systems post-Ebola. However, community involvement in decision-making and feedback mechanisms remained limited. Significant systemic challenges were identified, including inadequate trained personnel (M = 3.22), inconsistent drug supply (M = 2.91), and underdeveloped referral and medical equipment systems. Regression analysis showed that availability of trained health personnel (β = 0.241, p = 0.001) and consistent drug supply (β = 0.198, p = 0.012) significantly predicted community readiness. Conclusion: While community engagement in Sierra Leone's PHC system has improved, significant systemic barriers continue to undermine its effectiveness. The interdependence between community readiness and institutional capacity underscores the need for a dual strategy: enhancing health system infrastructure and fostering participatory governance. Targeted investments in workforce development, supply chains, and inclusive health planning are essential to achieving resilient, people-centered PHC. These findings offer valuable insights for policymakers and stakeholders committed to advancing universal health coverage in post-crisis contexts. Keywords: Primary health care, community readiness, Ebola aftermath, Sierra Leone, health system resilience, public participation, health workforce, supply chain.

Psychology includes many subfields that study human thought and behavior. Some of the important ones include clinical psychology, which focuses on psychology, psychology, which studies psychological processes, and developmental psychology, which studies human development. While psychology studies how people interact in a social environment, there is also psychology in the workplace. These are just a few examples of the diversity in psychology. This makes psychology relevant for understanding human behavior and improving all aspects of life.

Tips on the essential skills you need to develop to be an effective leader and how to cultivate them

Tips on the essential skills you need to develop to be an effective leader and how to cultivate them