Parenting concerns, stemming from cancer's projected impact on children, are a common and significant source of emotional distress for parents. A quantitative synthesis of existing data is critically absent, and the role of modulating factors (e.g., male sex, single parenthood, and the number of children) remains unclear. This meta-analysis aims to quantify the association between parenting concerns and emotional distress in cancer patients, examining male sex, single parenthood, and number of children as key moderators. This systematic review and meta-analysis followed PRISMA guidelines. Searches (PubMed, Embase, PsycINFO, Airiti Library; inception-November 2025) identified observational studies of adult cancer patients with minor children. Data on parenting concerns, anxiety, and depression were extracted and appraised using a modified JBI Checklist. Correlations were synthesized. Meta-regression addressed the quantitative void, examining male sex, single parenthood, and number of children as key moderators. Publication bias and sensitivity were assessed. We included 12 studies (N = 3895). Our meta-analysis found significant positive associations (r = 0.50, p < 0.001) between parenting concerns and both anxiety and depression. Meta-regression, controlling for time since diagnosis, identified male sex, single parenthood, and fewer children as significant moderators for anxiety (p < 0.001), with similar trends for depression. This meta-analysis highlights parenting concerns linked to distress in cancer patients, with fathers, single parents, and those with fewer children particularly vulnerable. Routine assessment and tailored, family-centered psychosocial interventions are urgently needed. This systematic review was registered with the International Prospective Register of Systematic Reviews and Meta-analysis (PROSPERO; Registration No. CRD42024592899).

The cause of medical errors and adverse events in healthcare is multifactorial and includes faulty systems, processes, and conditions that can lead individuals to make mistakes. These mistakes are estimated to cause between 210,000 and 400,000 preventable deaths each year in the United States and are often caused by ineffective communication and teamwork failures among interdisciplinary team members. Effective communication is crucial, especially during critical events as this impacts health care quality and patient safety. The project's aim was to implement the identified best practice of Team Strategies and Tools to Enhance Performance and Patient Safety (TeamSTEPPS) 3.0 to improve communication and teamwork during critical events on a perinatal unit. This was an evidence-based practice project consisting of 2 h of TeamSTEPPS didactic and interactive instruction followed by using the TeamSTEPPS concepts during 2 h of critical event simulation training to assess the perception of communication and teamwork of a multidisciplinary team on a perinatal unit. The multidisciplinary team members included labor and delivery nurses, mother/baby nurses, hospital aides, ward clerks, obstetrical technicians, obstetricians, and midwives. Using the TeamSTEPPS Teamwork Perception Questionnaire (T-TPQ), the perception of communication and teamwork was compared pre- and post-implementation. Communication and teamwork mean scores from pre to post increased by 61% and 56%, respectively. The mean posttest scores improved for each of the T-TPQ measures, indicating the intervention had an impact on each of the dimensions of the TeamSTEPPS approach, including team function, team leadership, situational monitoring, mutual support, and communication (p < 0.01) and Cohen's dz, of 0.82-1.32 provided evidence of a large effect. This evidence-based practice project provided clear and specific guidance for communicating and strengthening teamwork during perinatal critical events. Implementing TeamSTEPPS strategies can provide a safe environment for patients and a positive work environment where teamwork and communication are encouraged.

Chronic kidney disease (CKD) is a significant public health problem that requires effective preventive and conservative methods to limit morbidity and death. This study aims to give clinical practice an evidence-based basis for the clinical practice of healthcare professionals by methodically looking for the best available data on conservative strategies and CKD prevention in high-risk and early-stage patients. The 6S evidence resource model was followed and states that evidence retrieval was done top-down, gathering necessary studies from January 2014 to July 30, 2024. Databases searched included BMJ Best Practice, DynaMed, NICE, GIN, SIGN, JBI Evidence Synthesis, JBI Evidence Implementation, Cochrane Library, and PubMed. Following the JBI grade of evidence and recommendation methodology, two reviewers independently examined and assessed the literature, extracting and summarizing evidence. Seventy-nine publications were identified: 18 guidelines, 1 randomized controlled trial, 2 expert consensus statements, 36 evidence summaries, and 22 systematic reviews and meta-analyses. Key findings were summarized across eight aspects: risk assessment and early detection, risk factors and prevention of genetic factors, management of diabetic nephrology, impact of bariatric surgery on preventing CKD, screening and diagnosis, treatment and prevention strategies, lifestyle modifications, and CKD prevention. This study summarized the best evidence for preventing CKD from eight aspects, which can help clinical or community medical professionals develop and apply CKD preventive strategies for high-risk groups and early-stage patients. By using these evidence-based strategies, healthcare professionals can reduce the incidence and progression of CKD, leading to fewer hospitalizations, improved kidney function preservation, and enhanced long-term survival and quality of life for patients. Future research should address identified gaps and explore the implementation of these strategies in diverse clinical settings.

Human papillomavirus (HPV) is a major contributor to several preventable cancers. Although the HPV vaccine is recognized by the Centers for Disease Control and Prevention (CDC) as safe and effective, uptake among U.S. adolescents remains below optimal levels. Disparities in vaccination rates are shaped by both individual characteristics and social determinants of health (SDOH). To systematically review and synthesize the literature examining individual factors and social determinants of health associated with HPV vaccine initiation and completion among adolescents aged 9-18 years in the U.S. A systematic search was conducted in accordance with PRISMA guidelines, yielding 37 eligible studies from an initial pool of 2092 articles. The STROBE checklist was used to assess methodological quality, and the Levels of Evidence framework by Melnyk and Fineout-Overholt guided appraisal of study strength. Across included studies, initiation and completion rates averaged 47% and 40%, respectively. Key predictors of higher vaccine uptake included provider recommendation, health insurance coverage, urban residence, older age, and higher parental education. Disparities were most evident among adolescents living in rural areas and those from minority or low-income backgrounds. Barriers reported in several studies included parental safety concerns and logistical challenges. Evidence regarding parental knowledge and attitudes was mixed: smaller studies suggested an influence, whereas the largest population-based study reported no significant effect. Addressing HPV vaccination disparities requires a multifaceted approach, including improving healthcare access in underserved regions, strengthening provider-parent communication, and implementing policy interventions such as school-based vaccination programs and state mandates. Normalizing HPV vaccination as part of routine adolescent care is essential for reducing HPV-related cancer morbidity and mortality. These findings also have implications for catch-up vaccination in young adults aged 15-26 and shared clinical decision-making up to age 45, which remain important strategies for increasing protection across the lifespan.

Evidence-based practice (EBP) is widely endorsed as a cornerstone for high-quality, patient-centered care. However, its integration into daily clinical routines remains inconsistent, particularly in settings where cultural, educational, and organizational challenges persist. Reliable, contextually adapted tools are essential to measure EBP implementation and guide improvement efforts. This study aimed to validate the Italian versions of the EBP Implementation Scale and its short-form (3-item) version. A cross-sectional survey design was adopted. Both versions of the EBP Implementation Scale were translated and culturally adapted in accordance with internationally recognized guidelines. Data were gathered from a national sample of 405 nurses through a combination of convenience and snowball sampling. Psychometric assessment encompassed confirmatory and Bayesian factor analyses, evaluation of internal consistency and test-retest reliability, and measurement invariance testing. All analyses were performed in R Studio. Confirmatory factor analyses confirmed that both versions (long and short) of the scale measure a single underlying construct. The instruments demonstrated high reliability (ω = 0.96 and 0.87 respectively). Measurement invariance across educational groups was partially established, as the partial scalar invariance model demonstrated acceptable fit (CFI = 0.991, RMSEA = 0.045), suggesting consistent interpretation of the scale across different levels of EBP training. Latent profile analysis revealed distinct subgroups of EBP implementers, with notable differences in latent means (p < 0.001) associated with previous education in evidence-based practice. The Italian EBP Implementation Scales are valid and reliable tools for assessing EBP implementation behaviors. They can support education planning, monitor practice changes over time, and inform interventions aimed at enhancing evidence-based care.

Authentic leadership holds great potential to impact positive nursing and organizational outcomes. However, authentic leadership's connection to organizational culture, self-efficacy, and work engagement remains underreported. To investigate the associations of authentic leadership, organizational culture, self-efficacy, and work engagement among nurses. Cross-sectional and correlational design employing consecutive sampling in recruiting nurses (n = 534) between May and October 2024. Four validated self-report scales were used to collect data. Structural equation modeling analysis was used to examine the study variables' interrelationships. Organizational culture significantly predicted authentic leadership (β = 0.91, p = 0.004), while authentic leadership significantly influenced both self-efficacy (β = -0.16, p = 0.041) and work engagement (β = 0.57, p = 0.001). Meanwhile, self-efficacy directly and positively influences work engagement (β = 0.24, p = 0.002). Organizational culture had significant indirect effects on both self-efficacy (β = -0.14, p = 0.042) and work engagement (β = 0.48, p = 0.001) through the mediation of authentic leadership. Finally, self-efficacy mediated the association between authentic leadership and work engagement (β = -0.04, p = 0.002). The study shed light on the complex and interwoven relationships among several essential constructs-specifically, authentic leadership, organizational culture, self-efficacy, and work engagement. These factors collectively contribute to the creation and maintenance of a dynamic and supportive working environment for nurses.

Integrating evidence-based practice (EBP) into nursing is critical for improving clinical outcomes, yet adoption remains limited due to ongoing individual and organizational barriers. The EBP Scholars Program was developed to overcome barriers and foster a culture of evidence-based nursing practice within a pediatric healthcare system. Launched in 2007 during the organization's Magnet journey, the program is grounded in scientific, educational, and implementation science principles. Selected through a competitive application process, scholars engage in a seven-month structured curriculum grounded in the 8 A's Model of EBP. Learning outcomes are evaluated using pre- and post-program scores on the Evidence-Based Practice Knowledge Assessment Questionnaire (EBP-KAQ). The program has enrolled 147 participants and graduated 124. On average, participants increased their EBP knowledge by 15.7%. Scholar-led projects have led to over 40 policy updates, new care guidelines, and measurable quality and safety improvements. Graduates have produced 43 posters, 18 podium presentations, and 9 peer-reviewed publications. The EBP Scholars Program offers a scalable model for embedding EBP in healthcare. Through strategic leadership, interdisciplinary collaboration, and structured mentorship, it has advanced evidence-based care, professional development, and a culture of continuous improvement.

ABSTRACTBackgroundTechnology‐assisted interventions offer a promising alternative to conventional cardiac rehabilitation. However, there is limited evidence on their effectiveness, particularly in non‐Western settings with emphasis on exercise self‐efficacy.AimsTo evaluate the effects of a 12‐week, technology‐assisted hybrid cardiac rehabilitation (TecHCR) program on physical, physiological, and psychological outcomes of patients with coronary heart disease.MethodsA two‐arm parallel randomized controlled trial including 160 participants was randomly assigned to either TecHCR or usual care. TecHCR was underpinned by the Health Belief Model, consisting of three supervised exercise training and occupational therapy sessions, a fitness watch for exercise self‐monitoring, six audio‐visual educational videos, and a weekly video call follow‐up. Data were collected at baseline, immediately post‐intervention, and at 24 weeks post‐intervention.ResultsParticipants in TecHCR demonstrated significantly greater improvement in exercise self‐efficacy (β = 5.909, 95% CI [3.146, 8.672]; p < 0.001), health‐promoting behaviors (β = 9.058, 95% CI [5.524, 12.591]; p < 0.001), and perceived anxiety levels (β = −1.255, 95% CI [−1.893, −0.616]; p < 0.001) at immediate post‐intervention and (β = 8.506, 95% CI [4.951, 12.061]; p < 0.001, β = 14.563, 95% CI [8.809, 20.317]; p < 0.001, β = −1.145, 95% CI [−1.975, −0.315]; p = 0.007, respectively) 24 weeks post‐intervention when compared with the control group. No statistically significant improvements were observed in perceived depression and cardiovascular risk factors.Linking Evidence to ActionThe TecHCR program, combining supervised sessions with technology‐assisted components, is an effective approach for significantly improving exercise self‐efficacy, health‐promoting behaviors, and anxiety in patients with coronary heart disease. Healthcare institutions should consider implementing hybrid programs to overcome barriers to traditional cardiac rehabilitation, leveraging technology to extend support and maintain patient engagement beyond supervised sessions.Trial Registrationclinicaltrials.gov identifier: NCT04862351

The research-to-practice gap often occurs when evidence-based practice (EBP) is inadequately implemented into clinical practice. Nurses are critical to bridging the gap in EBP implementation (EBPI) and identifying effective strategies to promote its use in practice; however, they need a supportive work environment to develop the necessary research capacity/culture (RCC). The purpose of this study was to examine relationships between nurses' perceptions of individual RCC and EBPI, team RCC and EBPI, and health care organization RCC and EBPI, adjusting for educational background, health care organization setting, and health care organization type. Survey data were collected from 175 nurses across the United States using a prospective cross-sectional study design. The Research Capacity in Context (RCC) tool and EBPI scale were used to measure nurses' perception of RCC and nurses' EBPI, respectively. Simple linear regression was used to assess the relationship between organizational, team, and individual RCC and EBPI. Multiple linear regression was used to adjust for pertinent participant demographics. The results of this study indicated that organization (R2 = 0.033, p = 0.016), team (R2 = 0.064, p < 0.001), and individual (R2 = 0.155, p < 0.001) RCC were significantly associated with nurse EBPI. Moreover, findings remained significant after adjusting for educational background, health care organization setting, and type. The regression model suggested that education significantly predicted EBPI (R2 = 0.142, p < 0.001). These results emphasize the importance of building RCC in health care organizations, as it can be an effective strategy to increase nurses' EBPI, which has been shown to impact patient outcomes directly. Future research should identify strategies to assist organizations and leadership in building RCC among nurses.