BackgroundStroke is a leading cause of disability globally, with increasing prevalence in sub‐Saharan Africa. Little is known about how Tanzanian survivors navigate recovery within their social and healthcare environments. This study aimed to explore stroke survivors’ lived experiences of barriers to accessing and utilizing poststroke management services at a tertiary hospital in Tanzania.MethodsA qualitative study using an interpretive descriptive approach was conducted among stroke survivors attending follow‐up care at a tertiary referral hospital in Tanzania. A homogeneous purposive sampling strategy was used to recruit participants who shared key characteristics relevant to the study. The sample comprised 20 stroke survivors, including 8 males and 12 females. In‐depth interviews were conducted and analysed using reflexive thematic analysis to identify patterns of meaning across participants’ experiences.ResultsFour interrelated themes captured survivors’ experiences: (1) living with financial uncertainty, where costs of care and prescribed diets created practical and emotional barriers; (2) making sense of care amid constraints, reflecting adaptive decision‐making and reliance on personal beliefs or home remedies; (3) negotiating healthcare relationships, highlighting family support and the importance of ongoing communication with providers and (4) enduring the healthcare system, where long waiting times, administrative hurdles, frequent provider changes and conditional access disrupted continuity of care.ConclusionStroke recovery in Tanzania extends beyond clinical treatment, which is shaped by intertwined socioeconomic, relational and health system influences. Strengthening discharge planning, enhancing continuity of professional support, integrating family‐centred rehabilitation and leveraging mobile health technologies may improve equitable engagement with stroke care in resource‐constrained settings.

BackgroundMeaningful work is a critical psychological resource that enhances nurse engagement, retention, and quality of patient care. Organizational factors, including perceived organizational support, psychological safety, and organizational justice, play key roles in shaping nurses’ perceptions of meaningful work. While previous studies have examined these factors individually, limited evidence exists on how they interact.AimTo explore the relationships between perceived organizational support, psychological safety, and organizational justice in enhancing nurses’ meaningful work.MethodsThis multicenter cross‐sectional study surveyed a convenience sample of 349 nurses from four general hospitals. Data were collected using online survey, and partial least squares approach was employed to examine the hypothesized relationships.ResultsPerceived organizational support was positively associated with meaningful work (β = 0.421, p < 0.001) and psychological safety (β = 0.319, p < 0.001), whereas organizational justice was positively associated with psychological safety (β = 0.287, p < 0.001). Psychological safety was positively associated with meaningful work (β = 0.199, p < 0.01) and partially mediated the associations of perceived organizational support (β = 0.064, p < 0.05) and organizational justice (β = 0.057, p < 0.05) with meaningful work. Moderated mediation analysis revealed a small but statistically significant negative effect of organizational justice on the association between perceived organizational support and psychological safety (f2 = 0.015), and the indirect association of perceived organizational support with meaningful work via psychological safety was weaker at higher levels of organizational justice.ConclusionMeaningful work among nurses is supported by organizational support and fairness through psychological safety. High organizational justice may reduce reliance on perceived support. Nurse leaders should foster fair, supportive environments and policies that promote psychological safety, recognition, and engagement, ultimately enhancing retention, well‐being, and patient care.

Innovation in nursing education curricula is essential to support the evolving challenges of contemporary nursing practice and the difficulties of healthcare systems. However, transitioning to a new curriculum presents significant challenges for nurse educators, who must rapidly adjust to content revision, teaching methods, and assessment strategies, often in the context of limited institutional support. To identify the best available evidence for nurse educators transitioning from one curriculum to another in nursing education institutions (NEIs). Whittemore and Knafl's five-stage framework was used to conduct an integrative literature review: problem identification, literature search, data evaluation, data synthesis, and data presentation. A structured search was performed across CINAHL, EBSCOhost, Google Scholar, Medline, and Scopus. Eligible studies were published in English between 2010 and 2024, available in full text. No geographical limitations were applied to ensure a global perspective. Studies published before 2010 and those not aligned with the research objective were excluded. The selection process was reported in accordance with the preferred reporting items for systematic reviews and meta-syntheses guidelines, and Covidence software was used to facilitate systematic screening and appraisal, following the critical appraisal skills program guidelines. Analysis of 22 articles yielded five themes: leadership influence and change management; lack of quality assurance in NEIs; inadequate resources to implement a new curriculum; stakeholder engagement, ownership, and collaboration; and faculty capacity development and training needs for curriculum implementation. This review concludes that meaningful and sustainable curriculum change in NEIs demands a whole-system, strategically led approach characterized by inclusive leadership, institutional readiness, coordinated resourcing, faculty development, and stakeholder engagement to overcome historical challenges and effectively prepare competent, adaptable graduates for the complexities of 21st-century healthcare.

ObjectiveThis study aimed to investigate the dyadic relationship between illness perception, emotion regulation strategies, and posttraumatic growth in patients with lung cancer undergoing chemotherapy and their family caregivers.MethodsThis study used a cross‐sectional approach to collect data from 332 pairs of lung cancer patients receiving chemotherapy and family caregivers from China. Participants completed the Brief Illness Perception Questionnaire, the Emotion Regulation Questionnaire, and the Posttraumatic Growth Inventory. The actor–partner interdependence effects were used to analyze how illness perception and emotion regulation strategies affect posttraumatic growth in the patients themselves and their family caregivers.ResultsBoth illness perception and emotion regulation strategies had significant actor and partner effects on posttraumatic growth in patients with lung cancer undergoing chemotherapy and their family caregivers. Emotion regulation strategies were categorized as cognitive reappraisal and expressive suppression, and patients had lower scores than caregivers for posttraumatic growth, illness perception, and expressive suppression, except for cognitive reappraisal scores, which were higher than caregivers. In patient–caregiver dyads, cognitive reappraisal was positively associated with posttraumatic growth in themselves and each other, whereas both illness perception and expressive suppression were negatively associated with posttraumatic growth.ConclusionReducing negative illness perceptions and expressive suppression may promote posttraumatic growth in patients with lung cancer undergoing chemotherapy and their family caregivers. Facilitating cognitive reappraisal may be useful in enhancing posttraumatic growth, which provides direction for future intervention research. Healthcare professionals should view lung cancer chemotherapy patients and their family caregivers as a whole and develop dyadic interventions.

The spread of new educational technologies has challenged the cold and inflexible framework of traditional education, aiming to replace centuries-old methods with short, low-cost methods to improve learning and educational productivity. Thus, this study aimed to compare the effects of artificial intelligence (AI) and escape rooms (ERs) on e-learning satisfaction and the skill of arterial blood gas (ABG) interpretation in nursing students. The current study was conducted as a quasi-experiment on 91 nursing students in the third to sixth academic semesters, with a convenient sampling approach to AI, ER, and control groups by balanced block randomization. In the AI group, participants used ChatGPT; the ER group used the Twine platform; and the control group used the traditional method once a week. The E-learning satisfaction scale (ELSS) and arterial blood gas interpretation scale (ABGIS) were filled before and two weeks after the end of interventions. Data were analyzed using descriptive and inferential statistical tests in SPSS V.25 at a 0.05 significance level. In comparison to ER and control, AI significantly enhanced e-learning satisfaction and ABG interpretation (p < 0.001). In terms of content, interface, and communication satisfaction, AI demonstrated superiority over ER (p < 0.001). The intervention made a big difference-explaining nearly 90% of the changes in ELSS and about 40% in ABGIS. Among all the factors, AI stood out the most, driving major improvements in both learning outcomes and student engagement. The use of AI compared to the educational ER and conventional methods significantly increases the learning of ABG interpretation and satisfaction with e-learning. It is suggested that the positive and effective capabilities of AI be used as an educational assistant to enhance learning and teaching experiences in medicine and nursing.

To investigate the current status of treatment burden in stroke patients and analyze its associated factors, thereby providing a theoretical basis for clinical interventions. This study used a convergent parallel mixed-methods design. For the quantitative phase, a questionnaire survey was conducted among hospitalized stroke patients using convenience sampling from April to October 2024. Univariate analysis, correlation analysis, and multiple regression analysis were used to identify the associated factors of treatment burden. For the qualitative phase, purposive sampling was adopted, and the Colaizzi seven-step method with NVivo 11 software was used to analyze the specific manifestations and experiences of treatment burden in stroke patients. The quantitative and qualitative results were finally integrated and triangulated for joint presentation. A total of 237 valid questionnaires were retrieved. Multiple linear indicated that depression (β ' = 0.431, p < 0.001), self-management efficacy (β ' = -0.235, p = 0.047), age (β ' = -0.213, p = 0.001), objective support (β ' = -0.171, p = 0.001), and diet control (β ' = -0.163, p = 0.001) were the main associated factors of treatment burden of stroke patients. Seventeen stroke patients were interviewed for the qualitative phase, from which 8 themes and 27 subthemes were extracted. Integration of quantitative and qualitative results yielded a comprehensive, multidimensional understanding of treatment burden in stroke patients. Treatment burden in stroke patients is associated with multiple factors, involving psychological, behavioral, and social support dimensions. This finding emphasizes the necessity for healthcare professionals to adopt a holistic approach to stroke patient care. This study suggests that clinical practice should strengthen psychological interventions for stroke patients, improve their self-efficacy, provide individualized guidance, and refine support systems, so as to effectively alleviate treatment burden.

BackgroundThe global nursing shortage has become a critical issue, worsened by poor working conditions, demographic shifts, and the COVID‐19 pandemic. Understanding nursing students’ preferences and expectations is crucial for improving workforce retention, guiding decision‐making, and enhancing job satisfaction. This study aimed to explore nursing students’ preferences and expectations regarding working environment dimensions and analyze differences by gender and generation.MethodsA quantitative descriptive cross‐sectional study was conducted using an online survey targeting 1277 nursing students from Catalan universities between March 27 and June 26, 2023. Convenience sampling was applied. Preferences and expectations for all items were recorded on a scale from 0 (minimum) to 10 (maximum), and responses were regrouped into three categories: low (0–4), moderate (5–7), and high (8–10). Data analysis was conducted using R (version 4.3.0) under RStudio (version 2023.03.0). The Kolmogorov–Smirnov test confirmed non‐normal distribution of continuous variables. Comparisons by gender and generation were made using chi‐square tests, with significance set at p < 0.05. Cronbach’s alpha was used to assess internal consistency for the questionnaire items, confirming the reliability of the survey dimensions.ResultsA significant gap was found in high category (scores 8–10) between nursing students’ preferences, which exceeded 80% for all working environment dimension items and their expectations, which remained below 50% in all cases, indicating a noticeable disparity.ConclusionsThe study highlights a significant discrepancy between nursing students’ high preferences (> 80%) for working environment dimensions and their low expectations (< 50%) of achieving them. This gap suggests that improving work conditions and recognition could stabilize the nursing workforce.

ObjectiveTo determine participants' pre- and post-training competence in perinatal bereavement care, along with evaluation of the training.MethodsA quasi-experimental study with a pre–post design was conducted in two phases. The training on coping with perinatal loss (TCPL) was first delivered entirely online to a cohort of students in 2022(N = 56). To enhance the initial intervention, a second cohort of students in 2023(N = 44) received the TCPL with an added on-site scenario simulation component. Questionnaires of Perinatal Bereavement Care Competence Scale, Self-Competence in Death Work Scale, Jefferson Scale of Empathy, Chinese version of the Stress-Related Growth Scale-Short Form, and the evaluation of scenario simulation were used to evaluate the effectiveness of the training.ResultsIncluding 52 junior undergraduate midwifery students in 2022 and 44 in 2023 completed the questionnaires. We observed higher post-training scores for perinatal bereavement care competence and stress-related growth, and a high degree of satisfaction in the scenario of simulations.ConclusionsThe results support the feasibility of the training and are consistent with short-term improvements; confirmatory controlled studies are warranted.Trial RegistrationChinese Registry of Clinical Trials: ChiCTR2200066048

Background: Central venous catheters (CVCs) are crucial for critically ill patients but pose risks of complications and unplanned removal, which can interrupt treatment, prolong hospital stays, and increase mortality. This investigation sought to examine the occurrence and risk factors for unplanned CVC removal among intensive care patients in China.Methods: A multicenter cohort study was conducted across 22 public tertiary hospitals throughout China, from September 4, 2023, to February 29, 2024, enrolling critically ill patients with CVCs. Cox proportional hazards regression models were used to assess the risk factors for unplanned CVC removal.Results: The study comprised a total of 2680 first-time CVC insertion events (one per patient) in critically ill patients. 1151 (42.95%) CVCs were removed; most (n = 832, 31.04%) were elective. A total of 153 CVCs were removed prematurely (5.71%; 95% CI: 4.84–6.68), and infection-related complication was the leading cause (n = 124, 4.63%; 95% CI: 3.85–5.50; 5.26 per 1000 CVC days). Independent risk factors included male gender (HR, 2.04; 95% CI: 1.40–2.99; p < 0.001), neurological disorders (HR, 2.41; 95% CI: 1.50–3.86; p < 0.001), and mechanical ventilation (HR, 1.71; 95% CI: 1.09–2.70; p=0.02), while urgent insertion reduced the risk (HR, 0.52; 95% CI: 0.29–0.92; p=0.02). In subgroup analysis, diagnosis with neurological disorders (HR, 2.31; 95% CI 1.40–3.81, p=0.001), and urgent CVC insertion (HR, 0.41; 95% CI 0.21–0.82, p=0.01) were significantly associated with unplanned CVC removal in males but not in females (p > 0.05). No significant interactions were found between gender and diagnosis, mechanical ventilation, or urgent insertion (all p > 0.05).Conclusions: Unplanned CVC removal occurred in 5.71% of cases, primarily due to infection. Identified risk factors (male gender, neurological disorders, and mechanical ventilation) and protective factors (urgent insertion) highlight targets for preventive strategies in critical care.

AimTo test the structural validity and internal consistency of one (A-scale) of the two Professional Nurse Self-Assessment Scale II (ProffNurse SAS II) scales among graduating Nordic nursing students with the goal of assessing their psychometric properties when used separately.DesignThis study employed an explorative factor analyses to validate the ProffNurse SAS II A-scale items (n = 50) (self-assessed clinical competence).MethodsThe data were analyzed using jamovi Version 2.3.21. The suitability of the data for the planned analyses was assessed using established criteria for good model fit prior to conducting statistical tests. Exploratory factor analysis (EFA) was used to examine the underlying structure of one of the two scales, given its application in a new population and the lack of prior confirmation of its factor structure within this specific context. Internal consistency was assessed using Cronbach's alpha.Data SourcesConvenience sampling was used to select the participants among graduating nursing students in five Nordic countries. Data collection was made digitally during 2021–2022. A total of 274 graduating nursing students from five Nordic countries and 12 different universities completed the ProffNurse SAS II A-scale holding 50 items in local languages.ResultsEFA and parallel analysis elicited a five-factor solution accounting for 52.14% of variance in scores. Internal consistency reliability was supported with Cronbach's alpha of 0.960 for the ProffNurse SAS II A-scale. The five factors were named Direct Clinical Practice (1), Ethical and Collaborative Practice (2); Pharmaceutical Practice (3); Digital Coaching and Guidance (4); and Development and Leadership (5). The A-scale with a reduced number of items (from 50 to 44 items) showed proper structural validity and internal consistency for measuring self-assessed clinical competence and needs for further training among graduating nursing students.ConclusionsThe scale supports the study's theoretical framework and competencies of the graduating nursing students.Implications for the Profession and/or Patient CareSelf-assessment supports evidence-based practice and nursing education, and the ProffNurse SAS II A-scale offers a valid tool for measuring clinical competence among graduating students.Reporting MethodThe STROBE checklist for cross-sectional studies was adhered to, as well as the COSMIN reporting guideline.Patient or Public ContributionGraduating nursing students from five Nordic countries contributed to the study by answering the questionnaire.