Journal of Holistic Nursing Science

Your patients need your patience: A closer look at wound care

Eka Sakti Wahyuningtyas — Wed, 02 Jul 2025 00:42:42 +0000

The field of wound care faces various challenges in current times. Approaches to tackle the challenges require an understanding of biological processes, patient's psychological condition, and communication. Apart from physical care considerations, effective communication in wound care is very crucial to prevent misunderstandings and errors. The process warrant that the care is carried out effectively with minimum clinical complications. As the patient is an essential element in wound care, the use of good communication among healthcare professional becomes paramount. Specifically, tissue viability nurses must exhibit patience toward patients who might encounter difficulties in following the treatment or reject the proposed treatment. The importance of patience cannot be overstated in the context of wound care as it helps to manage stress, communication, and patients’ satisfaction. Moreover, patience strengthens the nurse–patient relationship and helps nurses stay well so they can support the nature of wound healing. Patience helps nurses manage challenging behaviors and improve the quality of interactions, both in hospital and community settings. Involving patients and families in goal setting and exploring questions requires time and patience. As a result, it can reduce short-term decision conflict and improve knowledge transfer between patients and healthcare professionals. Integrating clinical knowledge with compassion, effective communication, and determination can significantly support patients during the wound care delivery process. It is important to note that a comprehensive and evidence-based approach will be key to addressing challenges in wound care. The editorial presents a fresher perspective on how the patience in wound care influences the quality of practice. Such publications or studies discussing this concern would be so much helpful as insights or guidelines in wound care delivery.

Keywords: Communication, patience, patients, wound care, wound healing

An observational study of stress and coping among ICU nurses in Iraq through the lens of the Lazarus and Folkman model

Radhwan Hussein Ibrahim, Sahir Mallaah Mohammad Ali, Salwa Hazim Al Mukhtar — Mon, 14 Jul 2025 11:17:32 +0000

Intensive Care Unit (ICU) nurses face high-stress environments due to critical patient conditions, intense workloads, and emotional challenges. Understanding the specific stressors and coping mechanisms is vital for developing effective support interventions, which necessitates a framework like Lazarus and Folkman's model. For this reason, Lazarus and Folkman’s Transactional Model of Stress and Coping provides a theoretical framework to assess how nurses perceive and manage stress during their work. A descriptive cross-sectional study was conducted among ICU nurses at three public hospitals in Iraq. The study utilized a purposive sampling method to recruit participants. A total of 350 nurses participated in all phases of the study. Data collection was performed using the Nursing Stress Scale (NSS) and the Ways of Coping Questionnaire (WCQ), both of which were tested for validity and reliability. Statistical analyses included descriptive statistics, t-tests, ANOVA, and Pearson correlation. The study revealed that ICU nurses experience moderate to high stress levels (mean=82.4±14.6), with primary stressors being workload, death and dying, administrative deficiencies, and interpersonal conflict. Particularly, problem-focused coping strategies were used more commonly (mean=72.1±11.4) than emotion-focused strategies (mean=64.5±13.2). A negative correlation was found between stress and problem-focused coping (r=–0.48, p<0.001). Furthermore, a positive correlation was observed with emotion-focused coping (r=0.41, p<0.001). Higher stress levels were associated with younger age, female, and less ICU experience. The findings indicate that ICU nurses in Iraq experience significant occupational stress during the work. This highlights the importance of accentuating problem-focused coping strategies and organizational perspective in nursing. The study underlines the necessity for stress management interventions personalized to the Iraqi nurses working in the ICU.

Keywords: Coping, emergency nursing practice, Intensive Care Unit, nurses, stress

Quantitative analysis of infection prevention behaviors among patients receiving chemotherapy in Thailand: Predictors through the Bandura's Self-efficacy Theory

Wenika Srisoithongsug, Tiraporn Junda, Bualuang Sumdaengrit — Wed, 16 Jul 2025 11:22:59 +0000

Patients with advanced-stage cancer undergoing chemotherapy are highly susceptible to infections due to immunosuppression. Inappropriate behaviors further increase their risk of infection and severe complications such as not washing hands, consuming unsafe food, or exposure to contaminated environments. Consequently, nursing interventions are essential in promoting preventive behaviors and reducing infection risks. This study, therefore, examined the predictive power of infection prevention knowledge, distress, perceived self-efficacy, and social support on infection prevention behaviors in patients with advanced-stage cancer receiving chemotherapy. Bandura's Self-efficacy Theory was also integrated into the study's framework. This predictive study used a cross-sectional design that included 100 patients with advanced solid malignancy receiving outpatient chemotherapy at the King Chulalongkorn Memorial Hospital, Thai Red Cross Society, Thailand. Participants were selected through purposive sampling. Data were collected using the Knowledge of Infection Prevention in Cancer Patients Receiving Chemotherapy Questionnaire, the Thai version of the Distress Thermometer, the Thai Version of the General Self-Efficacy Questionnaire, the Social Support Questionnaire, and the Infection Prevention Behaviors in Cancer Patients Receiving Chemotherapy Questionnaire. Descriptive and multiple regression statistics with the Enter method were used for data analysis. Notably, this study received Institutional Review Board approval from two university hospitals in Bangkok, Thailand. The participants showed a high mean infection prevention knowledge score of 17.09 (SD=2.49), low distress (M=3.17, SD=2.78), moderate self-efficacy (M=30.40, SD=6.99), high social support (M=56.24, SD=6.71), and high infection prevention behaviors (M=105.85, SD=7.89). Regression analysis indicated that self-efficacy (β=0.244, p<0.05), distress (β=-0.233, p<0.05), knowledge (β=0.212, p<0.05), and social support (β=0.192, p<0.05) significantly predicted infection prevention behaviors, explaining 30.6% of the variance (p<0.05). These findings underscore that infection prevention behaviors are influenced by self-efficacy, distress, knowledge, and social support. Specifically, higher self-efficacy improves adherence to prevention and greater knowledge equips patients for effective infection control. Additionally, strong social support reinforces healthy behaviors. Conversely, high distress negatively impacts compliance with preventive behaviors. These insights can guide nurses in promoting effective infection prevention strategies for reducing infection risks.

Keywords: Advanced-stage cancer, cancer care, chemotherapy, infection prevention behaviors, nursing care

Exploring fathers’ experiences in newborn care in Indonesia: A phenomenological inquiry

Ayuda Nia Agustina, Anggi Pratiwi, Putri Mahardika — Fri, 18 Jul 2025 14:27:58 +0000

The critical role of fathers in newborn care and its impact on child development is gaining increasing recognition. This is because a father's involvement contributes to a child's physical health and emotional development. However, unique challenges inherent in newborn care often hinder paternal participation. These obstacles frequently stem from a lack of practical knowledge, insufficient social support, and prevailing cultural norms that tend to limit the father's role. Therefore, this study aimed to explore the experiences and perceptions of fathers concerning their involvement in newborn care. The study employed a qualitative design with a descriptive phenomenological approach. Data collection was conducted from February to May 2024 through semi-structured interviews, utilizing a purposive sampling method for selecting participants. A total of sixteen fathers who had children under the age of five participated in the study. Interviews were recorded, transcribed verbatim, and subsequently analyzed using content analysis, facilitated by NVIVO version 12 software. The data collection process was stopped once saturation was reached. Ethical clearance was obtained before the study began with all participants reading and approving informed consent for their involvement. The study documented six key themes that emerged from the fathers' experiences, father's perception, the impact of father's involvement, practical experiences, changes in their involvement, and the various challenges encountered in caring for newborns. The study highlighted that paternal involvement in newborn care is a complex process that demands comprehensive support. Pediatric nurses serve as fundamental role in recommending several interventions, including the development of evidence-based intervention programs, the integration of fathers' perspectives into health services, the conduct of advanced research with a wider scope, and the development of instruments to support fathers during the demanding period of newborn care.

Keywords: Caregiving, fatherhood, newborn care, paternal mental health, qualitative study

A phenomenological exploration of the lived experiences and self-management challenges among patients with type 2 diabetes living with neuropathy in Indonesia

Laode Saltar, Junaiti Sahar, Etty Rekawati, Dian Ayubi — Sat, 26 Jul 2025 04:47:03 +0000

Type 2 Diabetes (T2D) is a widespread chronic condition often complicated by Diabetic Peripheral Neuropathy (DPN). Over time, T2D with DPN can diminish a patient's capacity for self-management in their daily home life. Therefore, understanding patients' lived experiences in managing self-management is crucial to prevent further complications. However, studies exploring this critical concern are scarce, which can pose challenges for community nursing practice. This study intended to investigate the lived experiences, perceived barriers, and coping strategies related to self-management among patients with T2D and DPN. To achieve this objective, a phenomenological study design was utilized. A total of twelve participants were selected through purposive sampling. All participants had confirmed protective sensation loss, as evidenced by positive results from a 10g monofilament test. Data were collected through in-depth, semi-structured interviews conducted in the participants' homes between November 2021 and January 2022. Transcripts were analyzed verbatim using Colaizzi's method. The study identified five major themes: limited knowledge of diabetes self-management, varied blood glucose regulation strategies, barriers to diabetes care, physical and psychological consequences of DPN, and the crucial role of family and peer support in reinforcing treatment adherence. Nurses should emphasize the importance of family member engagement in daily diabetes care, as this provides essential practical and emotional support. Future nursing research should investigate intervention models that integrate educational support, community counseling, and family involvement across broader diabetes populations.

Keywords: Neuropathy, phenomenology, self-management, social support, type 2 diabetes

A descriptive study of anxiety levels and coping skills among university nursing students in Saudi Arabia

Mon, 04 Aug 2025 10:45:23 +0000

Social interaction anxiety is a prevalent and impactful form of anxiety. The condition is characterized by intense fear or distress in social situations where individuals anticipate negative evaluation or judgment by others. University students are vulnerable to social interaction anxiety due to new social and academic demands, such as public speaking, group participation, and interactions with faculty and peers. Moreover, these challenges are often heightened by transitions to unfamiliar environments that creating stressors then impair communication, engagement, and academic performance. However, there is a lack of studies addressing these issues among nursing students in Saudi Arabia. Therefore, this study aimed to explore the social interaction anxiety levels and coping skills among students at Riyadh Elm University, Saudi Arabia. The study used a descriptive design and employed purposive sampling to recruit 405 students who met the inclusion criteria. The sample size was determined based on an expected frequency of 50%, a confidence coefficient of 99%, and an acceptable error of 1%. Data were collected using the Social Interaction Anxiety Scale (SIAS) and Brief COPE Inventory. Descriptive statistics, Pearson correlation, independent t-test, and one-way ANOVA were used for data analysis. Ethical clearance was obtained prior to the study. The results showed that most participants (83.46%) exhibited low levels of social interaction anxiety, while 15.56% reported moderate levels. Female students reported higher levels of social anxiety than male students. The most common coping strategies were avoidance, altering consciousness, and seeking support, with seeking support being the most prominent. These findings highlight the need for community nurses to develop intervention strategies to address psychological problems among nursing students.

Keywords: Anxiety levels, coping skills, nursing students, research among students, social interaction anxiety

Cupping therapy in nursing higher education. How is it implemented in indonesia?

Fri, 15 Aug 2025 00:37:41 +0000

Cupping therapy is one of the most practiced Traditional Complementary Alternative Integrative (TCAI) therapies in Indonesia. It is important for educational institutions to integrate cupping therapy into higher education curricula in Indonesia. This will equip future healthcare professionals with the knowledge and skills to safely and effectively incorporate the practice. However, there is a lack of studies on how this therapy is incorporated into curricula in Indonesia. Therefore, this study aims to explore the inclusion of cupping therapy in nursing higher education curricula in Indonesia; specifically, whether such courses are available, how they are structured and delivered, and to identify other relevant information. A quantitative descriptive cross-sectional research design was utilized in this study to achieve the research objectives. The instrument used was a questionnaire about the cupping therapy curriculum, which was developed, tested, and validated prior to the commencement of the study. The tools consist of availability, aims and objectives, content organization, teaching methods, assessment and evaluation, curriculum communication, and process management. The data were collected from June 2022 to February 2023 from Muhammadiyah-affiliated nursing higher education institutions across Indonesia. A total of 42 institutions, comprise 70 nursing programs participated in the study. Ethical clearance was obtained from the Faculty of Health Sciences, Universitas ‘Aisyiyah, Yogyakarta, Indonesia. The findings highlighted that preserving local wisdom, accommodating public needs, and enhancing graduates with additional competencies were recognized by most participants as the main reasons for including cupping therapy in the curriculum. Most nursing programs incorporate cupping therapy as a subject within broader courses such as Holistic Nursing and Entrepreneurship. The integration of the cupping therapy curriculum has been implemented in Indonesia, though variations exist among nursing programs. At last, nursing education curricula should give greater attention to TCAI therapies including cupping therapy.

Keywords: Complementary and alternative medicine, cupping therapy curriculum, cupping therapy, holistic nursing, nursing education, nursing program development

The protective role of sense of humor against academic stress among Indonesian nursing students: A multivariate analysis

Budi Sarasati, Andreas Corsini Widya Nugraha — Tue, 02 Sep 2025 00:32:34 +0000

Nursing students often face academic pressure due to the dual demands of theoretical coursework and clinical responsibilities. This stress can impact their psychological well-being and academic performance. Recent studies suggest that humor may function as a psychological buffer that enhancing emotional resilience and students' capacity to cope with academic challenges. However, few studies have investigated this topic specifically among nursing students worldwide. Therefore, this study aims to examine the relationship between sense of humor and perceived academic stress among undergraduate nursing students in Indonesia. It also seeks to evaluate whether humor serves as a protective psychological factor after adjusting for relevant demographic variables. A quantitative observational study with a cross-sectional data collection method was conducted, involving 300 final-year nursing students. The study used the Multidimensional Sense of Humor Scale (MSHS) and an adapted Perceived Stress Scale (PSS) as instruments. To analyze the data, the study used descriptive statistics and bivariate analyses to identify variables for a multivariate logistic regression model. The study then used Adjusted Odds Ratios (AORs) to interpret the associations. Students with higher humor scores were significantly less likely to report high academic stress (AOR=0.363, 95% CI=0.224–0.589). This indicates that their odds of experiencing elevated stress levels were approximately 64% lower (1-0.363) compared to those with lower humor scores. Humor remained a significant predictor after adjusting for study duration. The final regression model explained 7.9% of the variance in stress status (Nagelkerke R²=0.079). Sense of humor may serve as a beneficial coping resource for reducing academic stress in high-pressure educational environments. Although the explained variance is modest, the findings support the inclusion of humor-promoting strategies in student mental health programs. Further nursing research is recommended to evaluate humor-based interventions across academic settings.

Keywords: Academic stress, emotion regulation, humor, nursing education, resilience

Barriers to quitting smoking among nursing students in Iraq

Mohanned Khaleel Abdullah, Nasir Muwfaq Younis — Tue, 09 Sep 2025 01:08:16 +0000

Tobacco use remains a significant contributor to health problems among nursing students in Iraq. If unresolved, it can lead to a substantial impact on mortality and morbidity. Therefore, smoking cessation is crucial to prevent further complications as mentioned in many publications. It is essential to conduct an observation on the prevalence of smoking among nursing students and the barriers to quitting. Although there is extensive research on this topic, it remains limited among population in Iraq. The purpose of the study is to assess barriers to quitting smoking among nursing students in Iraq. The study used a descriptive observational design and conducted at the College of Nursing, University of Mosul, Iraq. A total of 190 nursing students participated from three respective universities. Data collection was conducted using a comprehensive questionnaire administered to eligible nursing students within 7 January until 7 March 2024. The questionnaire comprised sections on demographic characteristics, smoking history, and barriers to smoking cessation. Prior to the main study, a pilot study was conducted with a separate group of participants who were not included in the original sample. To ensure content validity, the questionnaire was reviewed and validated by twelve experts from various medical and nursing fields. The data was analyzed using SPSS version 27 and presented in descriptive analyses across variables. The findings revealed that craving and friends' smoking were the primary barriers to smoking cessation. These results suggest that community nurses should collaborate with university authorities to develop comprehensive interventions. Furthermore, policymakers and university administrators may consider developing policies that include rewards for quitting and consequences for smoking among nursing students. Although this study was conducted in Iraq, the findings can serve as evidence that smoking cessation remains a global problem even in countries with a Muslim majority where smoking is believed to be prohibited.

Keywords: Barriers, community nursing, nursing students, smoking cessation, tobacco control measure

Blended learning using a crash cart and its effect on knowledge, skills, and clinical decision-making ability among nursing students

Kajal Thakur, Vinay Kumari, Amoldeep Amoldeep, Jyoti Sarin — Sun, 21 Sep 2025 22:28:50 +0000

A crash cart serves as a mobile hospital station equipped with all the supplies needed to handle a life-threatening emergency. Just as healthcare professionals rely on these carts to respond quickly and effectively in critical situations, educators can leverage innovative approaches like blended learning to meet the needs of their students. Blended learning creates a flexible and dynamic environment that supports diverse learning styles and enhances knowledge retention. However, there are limited studies investigating the impact of different learning styles among nursing students. This study aimed to assess the effectiveness of blended learning on nursing students' knowledge, skills, and clinical decision-making ability related to crash cart utilization. A quasi-experimental with control group pretest-post-test design was used to reach the study’s objective. This study was conducted at Maharishi Markandeshwar College of Nursing India from 23 April to 29 May 2024. The researcher determined the inclusion and exclusion criteria and then used convenience sampling to recruit participant. A total of 85 nursing students were included in the final analysis, divided into two groups: intervention and control. To avoid contamination, data from the control group was collected first then followed by the intervention group. Two blended learning models (Face-to-Face Driver Model and Rotational Model) were implemented throughout the study. The control group received a lecture and discussion covering theoretical elements, and educational videos for skill development were shared on Google Classroom. Meanwhile, the intervention group received a theoretical lecture followed by an online component accessed through a Learning Management System. Ethical clearance was obtained prior to the study commencement. The data was analyzed using descriptive statistics and independent t-test. The study found that the intervention group showed significantly better outcomes than the control group (p<0.05). Blended learning can be an effective approach for teaching emergency medications and operating emergency equipment. Therefore, nursing educators should incorporate practice sessions into their curriculum. This study suggests that blended learning, particularly the Face-to-Face Driver Model, is more effective than the Rotational Model.

Keywords: Blended learning, Face-To-Face Driver Model, learning in nursing, nursing education, Rotational Model

Sleep quality and psychological outcomes among shift nurses working in the hospital: A systematic review

Jheffany Bin Yazid, Azlini Binti Chik, Yuzana Binti Mohd Yusop — Sun, 21 Sep 2025 22:45:40 +0000

Poor sleep quality is a significant problem among shift nurses that leading anxiety, depression, and burnout. Understanding these associations is important since psychological distress will impact a nurse's performance, patient safety, and long-term ability. This systematic review examines the impact of sleep quality to psychological outcomes among nurses in hospital. The approach used systematic review design to reach the objective of the review. The review used a PRISMA flow diagram to transparently and systematically document the process of identifying, screening, and selecting articles. The research question is formulated based on the PICO guidelines. A systematic search of the literature between 2019–2024 was conducted across online databases such as Scopus, ScienceDirect, Web of Science, and Google Scholar. Screening for study quality was completed by using Joanna Briggs Institute (JBI) Critical Appraisal Checklist. A total of 1,245 articles were obtained through screening and a detailed review of the full text. The analysis comprised 19 studies from the various journals (n=7,391 nurses). The review highlighted that poor sleep quality ranged from a high of 94.5% to a low of 16.6%; the majority were emergency department nurses. Work-related stress, occupational patterns, and personal obligations were themes contributing to fatigue, anxiety, and depression. The results indicate a significant negative relationship between sleep quality and psychological outcomes for nurses. Interventions to enhance sleep quality and manage stress are critical for nurses. Furthermore, healthcare policymakers and hospital directors can develop more effective responses to address the psychological impact of shift work on healthcare workers. Increasing the number of incentives for nurses may help reduce the burden of working shifts.

Keywords: Clinical nurses, psychological aspect, sleep quality, systematic review, working shift

A systematic review of spiritual distress and needs among patients with cancer

Sun, 05 Oct 2025 11:44:04 +0000

Chronic illnesses such as cancer often lead to spiritual distress and unmet spiritual needs. These conditions cause patients to lose their sense of meaning in life and daily purpose. Furthermore, spiritual issues may have a significant impact on physical and psychosocial domains. However, reviews focusing on both aspects of spiritual distress and need are limited in the databases. Therefore, this project aims to synthesize quantitative evidence on the prevalence of spiritual distress and needs, and to identify its characteristics among patients with cancer. Of the various types of reviews, a systematic review was selected because it is well-suited to answer the review's objectives. The Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guideline was used during the process. The review involved four online databases, including PubMed, Scopus, Science Direct, and Taylor & Francis. Literature searches were conducted from August 2022 to June 2025. Two reviewers independently screened potentially eligible articles, and those meeting the eligibility criteria underwent quality appraisal using the Joanna Briggs Institute (JBI) Critical Appraisal Tools. Of 3745 potentially eligible studies, 17 were included in the review. Patients reported unmet spiritual needs that varied across geographic locations, including desires for prayer, inner peace, connection with significant others, and kindness. Spiritual needs were associated with psychological factors such as anxiety and depression. A high prevalence of spiritual distress was found among patients with cancer. Patients' spiritual distress and needs were influenced by demographic, clinical, and psychological variables. Therefore, establishing adequate assessment and appropriate spiritual care is fundamental for nurses working in the cancer area.

Keywords: Cancer, inner peace, prayer, religiosity, spiritual anguish, spiritual distress, spiritual need, spiritual pain

Impact of maternal chronic energy deficiency on newborns in developing countries: A scoping review

Sitti Marwah Al Maeka, Martha Irene Kartasurya, Siti Fathimah Pradigdo — Tue, 07 Oct 2025 07:29:20 +0000

Chronic energy deficiency (CED) among pregnant women in developing countries is a significant global health concern with direct implications for neonatal health. Despite the abundance of literature on CED, evidence specific to developing countries remains limited. This study aims to investigate the impact of maternal CED on birth outcomes and newborn health in these countries. Using a scoping review design, this study follows the Arksey and O'Malley framework and its modified version. Data were collected from multiple scientific databases, including PubMed/MEDLINE, Scopus, Web of Science, CINAHL, Cochrane Library, WHO Global Health Library, POPLINE, and regional databases to facilitate the inclusion of developing countries. The target population was pregnant women with CED in these countries. Studies published between 2015 and 2024 that reported on the relationship between CED and neonatal outcomes were included. A narrative analysis with thematic synthesis was conducted. The prevalence of CED in pregnant women in developing countries ranged from 25% to 43.1%. CED was associated with increased risks of low birth weight (OR=3.45; 95% CI=2.16-5.27; p=0.001), intrauterine growth restriction (IUGR), and neonatal complications. Factors such as maternal age <20 years (OR=2.17; 95% CI=1.35-3.47; p=0.002) and high parity (>4) exacerbated these risks. Long-term impacts included impaired cognitive development into adulthood. Maternal CED has a profound negative impact on newborn health. The findings reinforce the need for comprehensive health policies to reduce CED prevalence and mitigate long-term effects on children. To address this, we recommend integrating nutritional interventions into maternal health services, including routine CED screening, tailored counseling, food security enhancement, and women's empowerment. Cross-sectoral policies are essential to reduce CED prevalence and protect maternal and neonatal health outcomes.

Keywords: Birth weight, developing countries, energy deficiency, fetal growth, pregnant women

Islamic principles in nursing leadership: Lesson learned from Rufaida Al-Aslami’s lens and legacy

Marmi Marmi, Sujono Riyadi — Tue, 07 Oct 2025 07:43:58 +0000

Across global nursing perspectives, Non-Western contributions have been overlooked in favour of Western-centric views. A lesser-known yet influential figure, Rufaida Al-Aslami, laid the groundwork for a nursing model that emphasized both physical and spiritual well-being in the 7th century. As a leader and visionary, Rufaida embodied the principles of transformational nursing as inspiration future generations. However, limited attention has been given to the legacy in the context of nursing leadership in existing research. This perspective article re-examines Rufaida's legacy through the lens of decolonizing nursing historiography, outlining the Islamic-Informed Transformational Nursing Framework (IITNF) derived from her core principles such as rahmah (spiritual compassion), amanah and ihsan (ethical accountability), khidmah (community service), female collaborative leadership, and the integration in the daily nursing practice. These values challenge dominant epistemologies in nursing education that proposing an inclusive model rooted in social justice and spirituality. Reflecting on Rufaida's legacy highlights the importance of reclaiming non-Western narratives in global nursing. This article advocates for the strategic integration of faith-based and contextual care models into nursing practice and policy.

Keywords: Decolonizing nursing history, female leadership, Islamic nursing, Islamic-informed nursing framework, Rufaida Al-Aslami, value-based clinical practice

Carrying the torch of Nightingale’s legacy into health reform: A nursing perspective

Yunus Adhy Prasetyo, Aby Yazid Al Busthomy Rofi’i — Tue, 07 Oct 2025 07:54:42 +0000

Florence Nightingale transformed nursing by combining empirical observation with deep compassion that laying the groundwork for what is now recognized as evidence-based practice (EBP). Transcending the duties as a caregiver, Florence was a pioneer of health system reform that using data to challenge inequities and influence policy. This article revisits Florence’s enduring legacy and examines how it continues to shape the evolving role of nurses as both clinicians and change agents. From a nursing perspective, the article explores how EBP has become a cornerstone of modern clinical decision-making and health advocacy. It traces the historical development of EBP in nursing, its influence on patient care, safety, and system-level transformation. The article illustrates how nurses in diverse settings have successfully applied research evidence to drive meaningful reforms, improve outcomes, and advocate for human being populations. However, the integration of EBP into everyday practice is not without challenges. Barriers such as limited access to research, insufficient training, and organizational resistance remain significant. To address these issues, the article proposes strategic solutions—ranging from enhanced education and leadership development to stronger interdisciplinary collaboration. In reflecting on Nightingale’s visionary leadership, nursing practice now encompasses more than just bedside care. Nurses are uniquely positioned to use evidence in guiding interventions, influence policy and advance health equity through systemic change. In doing so, nurses continue to carry forward Nightingale’s mission by transforming healthcare through knowledge, compassion, and courage.

Keywords: Advocacy in nursing, Evidence-Based Practice, Florence Nightingale, health reform, nursing care

Environmental awareness training and nursing students' attitudes: A quasi-experimental study

Duygu Yeşilfidan, İrem Çalişkan, Merve Turhan — Thu, 16 Oct 2025 11:36:40 +0000

Environmental issues in nursing may not seem urgent since nursing primarily involves interacting with patients in hospitals or communities. For this perspective, studying nursing students' attitudes towards environmental issues is crucial. Unfortunately, research in this area remains scarce in the literature. Therefore, this study aimed to improve nursing students' attitudes toward environmental issues through a specific training program. The study employed a quasi-experimental pretest–posttest control group design that involving 164 students from the Faculty of Nursing at Aydın Adnan Menderes University, Türkiye. Of these, 79 students were assigned to the experimental group and 85 to the control group. Data were collected between November 2022 and July 2023. Intervention group received a 4-week training program related to environmental issues. In contrast, the control group received no usual or standard program. Prior to commencing the study, ethical clearance and informed consent were obtained. Data analysis was performed using SPSS; appropriate tests were selected based on normality results, and statistical significance was set at p<0.05. The study highlighted that the participants in the intervention group had significantly higher scores regarding environmental issues compared to the control group. These high scores were observed across all sub-dimensions, specifically in Receiving, Reacting, Valuation, Organizing, Personalizing, and Environmental Problems Attitude. The study's findings suggest that universities and governments should prioritize environmental education and literacy programs. This is essential for enhancing nursing care, particularly in community settings.

Keywords: Attitude, environmental issues, health education, nursing care, nursing students