The Malaysian Journal of Nursing (MJN)

Message from the Editor in Chief

2026-04-02

The nurses despite challenges, continue to uphold their fundamental commitment to life, dignity, and compassionate care. They remain on the front lines of health services, caring for the injured, supporting families experiencing profound distress, and maintaining essential healthcare delivery systems under conditions of significant personal risk. The ethical and professional obligations of the nursing profession compel nurses to provide care to those in need, regardless of the surrounding circumstances. Their continued dedication reflects the core values of nursing, including compassion, responsibility, and respect for human life. However, the ongoing threats to healthcare personnel and infrastructure raise serious concerns for the safety and sustainability of health services. The principle of medical neutrality requires that health services remain protected and free from interference.

In light of these realities, the global nursing and healthcare community must reaffirm its solidarity. Nurses are caregivers dedicated to preserving life and alleviating suffering. Ensuring that they are able to perform their duties safely, ethically, and with dignity. This is not only professional necessity but also a moral and rightful imperative for the international community. In this context, The Malaysian Journal of Nursing continues to play a vital role in presenting healthcare guidelines and advancing nursing practice by bringing forward the experiences and perspectives of nurses working on the front lines of care. The articles presented in this issue of the Malaysian Journal of Nursing further contribute to this mission by offering evidence-based insights, practical perspectives, and scholarly discussions that support the advancement of nursing knowledge, strengthen clinical practice, and ultimately enhance the quality of patient care across diverse healthcare settings.

Trauma-Informed Care Instruments for Nursing in Natural Disaster-Prone Areas: A Systematic Review

Eriyono Budi Wijoyo — 2026-04-02

Background: Nurses play a crucial role not only in clinical management but also in preventing psychological trauma, especially in disaster-prone settings. Trauma-Informed Care (TIC) is a key strategy, and its implementation requires the use of valid and reliable instruments. This systematic review aims to identify TIC assessment tools and analyze their application across different disaster phases. Methods: A systematic review was conducted following the PRISMA guidelines. Literature searches were performed in five databases (PubMed, ScienceDirect, Emerald, ProQuest, and Sage Journals) using keywords, covering publications from 2015 to 2024. Results: Nine TIC instruments were identified and grouped into three categories: (1) Individual attitudes and competencies The Attitudes Related to Trauma Informed Care (ARTIC), Knowledge, Attitudes, and Practices related to Trauma-Informed care (KAP-TIC), Nurses’ Intention to Care for Patients with Infectious Disease Scale (NICPS), Measuring TIC-Nurses). (2) Organizational readiness and culture (TICO Meter, Organizational Trauma Resilience Assessment (OTRA)), and (3) Specific clinical practices (TIC-PAT, Trauma-Informed Practice (TIP) Scale). Instruments such as ARTIC and the Trauma-Informed Care Provider Assessment Tool (TIC-PAT) are suitable for the initial phase of a disaster, allowing for the rapid assessment of healthcare workers. Meanwhile, TICO Meter and OTRA are effective for evaluating organizational readiness and resilience during response and rehabilitation. The TIP Scale is particularly relevant in the recovery phase to empower survivors. Conclusion: Nine TIC instruments can be integrated into different phases of disaster management: ARTIC and TIC-PAT for early assessment, TICO Meter and OTRA for organizational readiness during response and rehabilitation, and the TIP Scale for recovery. Training and systematic use of these tools enable nurses to deliver compassionate, safe, and resilient care in disaster-prone settings.

Translation and Validation of the Indonesian Version of the Diabetic Foot Ulcer Scale–Short Form (DFS-SF): A Psychometric Evaluation

Haryanto — 2026-04-02

Background: Diabetic Foot Ulcer (DFU) is a common chronic complication of diabetes that significantly impairs patients’ quality of life. However, a culturally adapted and validated Indonesian DFU specific quality of life instrument to support comprehensive nursing assessment is not yet available. Objective: This study aimed to adapt the DFS-SF (Diabetic Foot Ulcer Scale) into Indonesian using a standardized translation process and to evaluate its psychometric properties, specifically validity and reliability. Methods: This study used a cross-sectional quantitative design and recruited 118 patients from three urban wound care clinics. The original DFS-SF underwent forward-backward translation and cultural adaptation. Internal consistency and construct validity were examined using PLS-SEM (Partial Least Squares Structural Equation Modeling) analysis. Results: The Indonesian DFS-SF demonstrated robust psychometric properties, including high reliability and validity across all domains. Strong internal consistency was observed across all domains, with both Cronbach’s alpha and composite reliability > 0.80. The construct demonstrated adequate convergent validity, evidenced by Average Variance Extracted (AVE) values of 0.60 or higher, and by employing the Fornell-Larcker criterion, discriminant validity was verified. Outer loadings for most indicators were above 0.70, with particularly high loadings for Leisure (≥0.95) and daily activity (≥0.91) domains, indicating robust construct measurement. Conclusion: The Indonesian version demonstrated validity and reliability for assessing quality of life in patients with DFU. To enhance generalizability, future studies should include more diverse populations. This research suggests that the Indonesian version of the DFS-SF can be effectively applied in clinical settings to assess the quality of life among patients with diabetic foot ulcers.

Impact of Family-Oriented Maternity Support on Mothers' Confidence and Early Postpartum Emotional Distress

Ika Novita Sari — 2026-04-02

Background: A mother's self-efficacy and postpartum blues have a significant influence on the mother's ability to adapt and the quality of care provided to the baby. Another issue commonly observed in Indonesian health care, particularly in urban areas such as Batam, is the limited attention given to postpartum psychological problems in routine nursing care, which receives less attention. Family-Centered Maternity Care (FCMC) is a nurse-led, family-inclusive intervention to promote the mental health of mothers postpartum. Objectives: This research aims to determine the effectiveness of FCMC in increasing maternal self-efficacy and reducing postpartum blues among mothers who have given birth in Batam, Indonesia. Methods: A quasi-experimental pre-test post-test control group design was used to recruit 128 postpartum mothers (64 intervention, 64 control). The intervention was implemented through four structured FCMC sessions over two weeks, by maternal and child nurses, while the control group received routine care as usual. Maternal self-efficacy was assessed using the MEQ, whereas postpartum blues was assessed using the Postpartum Blues Questionnaire (PBQ). The Mann-Whitney U test, Wilcoxon signed-rank test, and Spearman's correlation were used for data analysis (p<0.05). Results: The intervention group had significantly higher post-intervention scores for maternal self-efficacy (mean= 69.72 ± 5.45) than the control group (mean= 38.25 ± 4.16; p<0.001), and lower postpartum blues scores (mean= 26.05 ± 3.66) than the control group (mean= 52.95 ± 4.13; p<0.001). Maternal self-efficacy and postpartum blues had a negative correlation (r =0.805, p < 0.001). Conclusion: FCMC has been shown to increase maternal self-efficacy and reduce postpartum blues significantly, making it a worthy addition to standard postpartum nursing practice.

Effectiveness of Shift Work Tolerance Intervention Program in Reducing Insomnia Symptoms among Shift-Working Nurses

Anggi Setyowati — 2026-03-24

Introduction: Shift-working nurses are at high risk of developing insomnia. However, few interventions have targeted Shift Work Tolerance (SWT) as a strategy to alleviate insomnia among shift-working nurses. Objectives: This study aimed to evaluate the effectiveness of SWT intervention in reducing insomnia symptoms among female shift-working nurses. Methods: A quasi-experimental pre-post-test control group design was conducted with 30 participants, who were assigned to intervention (n=15) and control (n=15) groups. The SWT program addressed circadian rhythm of sleep, sleep hygiene, occupational stressors, and coping strategies as well as stress management. Insomnia was assessed using the Regensburg Insomnia Scale (RIS) at baseline and one month after intervention. Data were analyzed using Wilcoxon and Mann–Whitney tests. Results: The intervention group showed significant improvements in insomnia outcomes, including reduced sleep latency, increased sleep duration and continuity, fewer sleepless nights, reduced fear of insomnia, and reduced daytime impairment compared with the control group (p < 0.05). The overall insomnia scores significantly decreased in the intervention group (Δ = 4.93, p = 0.001) but not in the control group (Δ = 2.21, p > 0.05). Conclusion: The SWT intervention was effective in reducing insomnia symptoms and improving sleep health among shift-working nurses. This approach may serve as a feasible strategy to enhance well-being and job performance in clinical practice.

Comprehensive Nursing Intervention for Managing Pain, Anxiety, and Malnutrition among Elderly Patients with Liver Cirrhosis

Zeinab Shaker Abdullah — 2026-04-02

Background: Liver Cirrhosis is a Chronic, progressive, and irreversible disease caused by vascular and hepatocellular injury. Comprehensive nursing intervention standardizes nursing responsibilities through an organized management system and may help improve pain, anxiety, and malnutrition in elderly patients. Objectives: To evaluate the effect of comprehensive nursing intervention on managing pain, anxiety and malnutrition in elderly patients with liver cirrhosis. Methods: Quasi-experimental research design was utilized. The study was conducted at the inpatient clinics of Al-Rajhy Liver Hospital, Assiut University, Egypt. A Purposive sample of 100 elderly patients diagnosed with liver cirrhosis was selected. divided equally into an intervention group 50 and a control group 50. Four tools were used: Tool I: Structured interview sheet. Tool II: visual analog scales. Tool III: - geriatric anxiety scale. Tool IV: mini nutritional assessment. Results: Findings revealed statistically significant improvements in the intervention group compared to the control group. Patients who received the comprehensive nursing intervention showed reduced levels of pain (p = 0.001), and anxiety scores were lower in the study group among participants who received visits (p = 0.009), as assessed by the visual analog scale and the geriatric anxiety scale, respectively. Additionally, nutritional status improved significantly (p < 0.05 for all variables). Conclusion: Comprehensive nursing interventions significantly enhance pain, anxiety, and improve nutritional status among elderly patients with liver cirrhosis. Incorporating these interventions into routine liver care is essential.

The Role of Nurse-led Health Education in Enhancing Treatment Adherence among Hemodialysis Patients: A Randomized Controlled Trial

Zainab Saeed — 2026-04-02

Background: For patients with end-stage renal disease, hemodialysis may be the only way to sustain life. However, it requires strict adherence to treatment to avoid its biopsychosocial burdens. Objectives: This study aims to estimate the efficacy of nursing health education based on the Theory of Planned Behavior (TPB) in improving treatment adherence among hemodialysis patients. Methods: This randomized controlled trial study involved 60 hemodialysis patients from the dialysis center of Telafer General Hospital, Nineveh, Iraq, from October 2024 to May 2025. The study participants were randomly divided into two groups (experimental group = 30 subjects and control group = 30 subjects). A specialized questionnaire consisting of the End-Stage Renal Disease-Adherence Questionnaire (ESRD-AQ) and TPB constructs scale was used in pre- and post-intervention tests to determine changes in adherence behavior, knowledge/perception, and TPB constructs over three time points (T0, T1, T2). Data was analyzed by descriptive and inferential statistics using the Statistical Package for Social Science (SPSS) software. Results: Most participants were in the age group of 60–69 years (21.7%). Statistically significant positive changes were noted among experimental group participants’ adherence behavior, knowledge/perceptions, and TPB constructs at post-tests 1 and 2 (p < 0.05). Intention was associated with attitude and perceived behavioral control (r = 0.442, 0.471; p < 0.05), respectively. In addition, intention was associated with treatment adherence behavior (r = 0.391). No significant changes or correlations in the study variables were observed among the control group participants over time. Conclusion: This study suggests that nursing health education based on TPB effectively improves treatment adherence among hemodialysis patients.

Navigating Nurses’ Lived Social Experiences during a Health Crisis in Sarawak: A Phenomenological Study

Ai Ling Chen — 2026-04-02

Introduction: Health is a dynamic and holistic state of well-being rather than merely the absence of illness. Social well-being among nurses is both a personal necessity and a professional imperative, as their interactions with patients, colleagues, families, and institutional systems fundamentally shape their professional identity and psychosocial health. Objectives: To explore the social experiences of nurses in Sarawak during the COVID-19 pandemic, with a focus on how their interactions with patients, colleagues, families, and healthcare systems shaped their sense of social well-being. Methods: Using a phenomenological approach, this qualitative study explored the lived, relational dimensions of nurses’ experiences. Data were collected through face-to-face semi-structured interviews with ten purposively selected nurses, continuing until data saturation was achieved. Thematic analysis followed the six-phase framework. Results: Four themes emerged: disrupted personal freedom and diminished social engagement; fractured family bonds and emotional strain; stigmatization and societal rejection; and multi-dimensional camaraderie. Nurses described feelings of isolation, disrupted routines, and strained familial ties, yet also found strength in shared experiences and institutional support. Conclusion: Social well-being emerged as a dynamic, relational construct shaped by both vulnerability and resilience. The integration of existential structures offers a deeper understanding of how nurses’ social realities were disrupted and redefined during the pandemic. These findings underscore the need for psychosocial support, relational leadership, and stigma-reduction strategies to safeguard nurses’ well-being during public health crises.

Analysis of Family Centered Care Needs in Treatment of Breast Cancer Patients Post Mastectomy

Mariza Elsi — 2026-04-02

Background: Breast cancer is the most common type of cancer among women in Indonesia. The impact of treatment and mastectomy is felt not only by the patients but also by their families as caregivers. Objectives: This study aims to identify the needs for Family Centered Care (FCC) among post-mastectomy patients after returning home. Methods: It was a mixed-method design with a sequential explanatory strategy that was used, involving members of a cancer support community. The quantitative phase involved 62 respondents who completed the FCC questionnaire. Results: The results showed that the highest needs were in the social and affection dimensions (mean = 18.65, SD = 1.839). To gain a deeper understanding of the reasons behind these findings and the contextual experiences of patients, a qualitative phase was conducted using narrative analysis with 11 participants. The qualitative phase yielded five main themes: (1) emotional experiences after mastectomy, (2) unmet basic needs, (3) the most helpful forms of family support, (4) challenges encountered during home-based care, and (5) expectations for improving health services. Conclusion: These findings highlight the importance of social and emotional support in the recovery process, alongside other essential needs. The study concludes that social and affection needs are the highest priority for breast cancer patients after mastectomy during home care; therefore, the implementation of comprehensive Family Centered Care oriented toward collaboration among nurses, patients, and families is essential to support optimal recovery.

Effectiveness of an Educational Program on Nurses' Competence Regarding Palliative Care of Children with Cancer in Mosul City

Evet Talal Bko — 2026-04-02

Introduction: Pediatric palliative care is essential for improving the quality of life of children with cancer and their families. Nurses play a critical role in delivering this care; however, many lack adequate training and competence in pediatric palliative care practices. Objectives: This study aimed to evaluate the effectiveness of an educational program on nurses’ competence in providing pediatric palliative care for children with cancer. Methods: A quasi-experimental, single-group design was conducted at Al-Hadbaa Specialized Hospital, Mosul, from September 15, 2024, to March 17, 2025. A purposive sample of 25 nurses participated. Data were collected using a structured tool covering socio-demographic characteristics, four domains of knowledge, and four domains of skills related to pediatric palliative care. Competence levels were assessed pre-program, immediately post-program (post-test I), and at follow-up (post-test II). Results: Prior to the intervention, 76% of nurses were classified as Needs Improvement, and 20% were classified as Very Low in overall knowledge. Following the educational program, knowledge levels improved substantially: in post-test I, 52% of nurses achieved good, and 44% achieved Excellent classifications. Further improvement was observed at post-test II, where 60% were classified as Excellent and 36% as Good. Similarly, baseline skill levels indicated that 76% of nurses were classified as Needs Improvement before the intervention. After program implementation, post-test I results showed 48% achieving Excellent and 44% achieving Good levels. At post-test II, 64% of nurses reached Excellent, and 20% were classified as Good, demonstrating sustained improvement. Statistical analysis revealed highly significant differences between pre-intervention and post-intervention phases (p < 0.001), with large effect sizes observed for both knowledge and skills. No statistically significant differences were found between post-test I and post-test II (p > 0.05), indicating retention of competence gains over time. Conclusion: The structured educational program significantly enhanced nurses’ knowledge and skills in pediatric palliative care, bridging initial competence gaps. These findings support the integration of similar training into in-service education and nursing curricula to strengthen pediatric oncology care in resource-limited settings.

Negotiating Work–Family Balance among Intensive Care Unit Nurses from the Managerial Perspective of Head Nurses: A Qualitative Descriptive Study

Yulia Hairina — 2026-04-02

Background: Intensive care unit (ICU) nurses experience persistent work–family tensions due to high-acuity care demands, rigid shift systems, and emotional labor, particularly among nurses who are also mothers. While organizational support has been widely examined, limited attention has been given to how work–family balance is negotiated and enacted within everyday managerial practice at the unit level. This study aimed to explore how ICU head nurses conceptualize, interpret, and exercise managerial discretion in supporting work–family balance within structural and institutional constraints. Methods: A qualitative descriptive study design was used. Seven ICU head nurses (N = 7) from seven hospitals in Borneo, Indonesia, were purposively recruited based on their managerial responsibilities. Data was collected through in-depth semi-structured interviews and analyzed using reflexive thematic analysis. Results: Three interconnected themes emerged: (1) Framing work–family balance as a contextual managerial dilemma characterized by structural and emotional complexity, differentiated needs, and tensions between professional accountability and flexibility; (2) Experiencing competing role demands under structural constraints, including scheduling rigidity, persistent maternal guilt, and the need to sustain professional vigilance amid personal distress; and (3) Enacting managerial negotiation within organizational constraints through conditional schedule adaptations, relational leadership, and structured shift-swapping mechanisms. Conclusion: Work–family balance in ICU settings is not achieved solely through formal policies but through ongoing managerial negotiation embedded in everyday practice. These findings highlight the pivotal role of head nurses as mediators of job demands and caregiving responsibilities and underscore the need for institutional structures that legitimize sustainable managerial discretion.

Exploring ICU Nurses’ Experiences in Delirium Screening using CAM-ICU: A Thematic Analysis

Nelly Hamdin — 2026-04-02

Background: Delirium is a common but under-identified complication in critically ill patients in intensive care units (ICUs). It leads to long hospital stays, high mortality, and high health care expenditure. Even though the Confusion Assessment Method of the ICU (CAM-ICU) is an instrument that has been validated to be used in the early detection, it is not regularly implemented in real practice. In Malaysia, there is little research on the experience of the ICU nurses as it relates to delirium screening after systematic educational programs. Methods:
This qualitative descriptive research study helped to understand the experience of ICU nurses who took part in a structured CAM-ICU educational intervention. Purposive sampling was used to select six ICU nurses in two privately owned tertiary hospitals in Johor, Malaysia. Interviews were done in a semi-structured format and transcribed verbatim. Member checking, peer debriefing, and audit trail maintenance were used to guarantee rigor. The data collection process was completed until thematic saturation was reached. Results:
Four general themes were identified, namely: issues in delirium screening, increased awareness about the significance of delirium, change in attitudes after education, and suggestions about how to help maintain screening habits. The barriers identified by the participants included the level of patient sedation and the large workload. Nevertheless, they also noted that they felt more confident, more motivated, and became more aware of the situation following the intervention. Peer support and managerial reinforcement were found to be significant to practice change maintenance. Conclusion: The CAM-ICU educational intervention in a structured form enhanced the knowledge and attitudes of the ICU nurses with regard to delirium assessment. Institutional commitment, workflow integration, periodic refresher training, and leader support are needed to maintain the implementation over a long period of time. Delirium screening in routine documentation and encouraging team-based interactions can contribute to long-term sustainability and could result in better patient outcomes.

Culturally Adapted Acceptance and Commitment Therapy to Improve Quality of Life, Self-Care and Treatment Adherence among Indonesian Hemodialysis Patients

Ponirah Ponirah — 2026-04-02

Background: Hemodialysis patients in Indonesia face multidimensional burdens impairing quality of life, self-care, and treatment adherence. While Acceptance and Commitment Therapy (ACT) show efficacy in chronic illness, culturally adapted interventions integrating local values remain scarce. Objectives: This study evaluated the effectiveness of a culturally adapted ACT module integrating Sundanese values (silih asih, silih asah, silih asuh) in improving quality of life, self-care, and treatment adherence among Indonesian hemodialysis patients. Methods: A quasi-experimental pre-test/post-test controlled study was conducted in a West Java hospital hemodialysis unit. Sixty adults on maintenance hemodialysis (≥3 months) were assigned to intervention (n=30) or control (n=30) groups by dialysis shift. The intervention group received eight 90-minute ACT sessions Acceptance and Commitment Therapy-Health & Depression - Sundanese (ACT-HD-Sunda) module over four weeks plus usual care; controls received only usual care. Primary outcomes included quality of life measured by the Kidney Disease Quality of Life Short Form (KDQOL-SF™) and self-care assessed using the End-Stage Renal Disease Self-Care Scale (ESRD-SCP). Secondary outcomes comprised treatment adherence measured by the End-Stage Renal Disease Adherence Questionnaire (ESRD-AQ) and psychological distress evaluated using the Depression Anxiety Stress Scales (DASS-21). Data analysis was performed using Multivariate Analysis of Covariance (MANCOVA) followed by Analysis of Covariance (ANCOVA) with Bonferroni correction. Results: MANCOVA revealed a significant multivariate effect, Wilks' Λ = 0.547, F (4, 51) = 10.57, p<0.001, partial η²=0.453. Follow-up analyses showed large effect sizes for quality of life physical (partial η²=0.373, Cohen's d=1.23), mental (partial η²=0.459, d=1.47), self-care (partial η²=0.521, d=1.78), and moderate-to-large for adherence (partial η²=0.311, d=0.98). All p<0.001. Adherence partially mediated quality of life improvement (20%). Intervention was 93.5%. Conclusion: The culturally adapted (ACT-HD-Sunda) module effectively improved quality of life, self-care, adherence, and psychological distress, supporting culturally responsive, family-centered nursing interventions in chronic disease management.

Nursing Students’ Expectations toward Digital Healthcare Marketing Strategies for Premarital Counseling: A Qualitative Study

Narges Fathi Mohamed — 2026-04-02

Background: Premarital counseling (PMC) represents an essential preventive intervention for promoting healthy marital relationships and family functions. However, its utilization among nursing students remains limited. Digital healthcare marketing strategies offer promising opportunities to enhance awareness and engagement. Objectives: This study aimed to examine nursing students’ expectations regarding digital healthcare marketing strategies for PMC promotion. Methods: A qualitative descriptive design was employed with the following Consolidated Criteria for Reporting Qualitative Research (COREQ) guidelines. Twenty nursing students were purposively selected from Mansoura University, Egypt. Semi-structured interviews were conducted via the WhatsApp messaging platform, using systematic thematic analysis procedures for data analysis. Results: Four themes emerged. Students anticipated that both official websites and social media (particularly Facebook) would be used for content delivery. The content type is expected to be concise videos and blog articles that use clear, evidence-based messages and simple language. Students looked forward to daily Arabic-language content with motivational messaging. Teaching methods are expected to include storytelling and practical tips. Nursing students expect digital healthcare marketing for PMC to be culturally responsive, simple, and inspirational. Content anticipated to engage the audience emotionally without compromising its evidence-based nature. Conclusion: Targeted digital campaigns can improve PMC awareness and prepare nursing students as future health educators. Academic institutions are recommended to collaborate with health educators to develop student-centered digital campaigns aligned with students’ media preferences. Community initiatives should be implemented to enhance digital literacy and awareness of online counseling tools, thereby improving access and engagement.

Prevalence and Associated Risk Factors of Restless Legs Syndrome in Iraqi Hemodialysis Patients: A Cross-Sectional Study

Ied Ali Omar Al-Sadoon — 2026-04-02

Background: In patients receiving hemodialysis, restless legs syndrome (RLS) is an underrecognized comorbidity that significantly reduces sleep quality and treatment compliance. Objectives: The purpose of this study was to assess the prevalence of RLS, risk factors, and implications for nursing care among hemodialysis patients in An Nasiriyah, Iraq. Methods: A cross-sectional study utilizing the International Restless Legs Syndrome Study Group's (IRLSSG) standardized criteria, involving 199 hemodialysis patients from January 2024 to March 2025. Participants were categorized into an RLS group (n=76) and a control group (n=123) based on the IRLSSG criteria. Demographic and clinical characteristics, along with laboratory data, were acquired via interviews and medical records. Statistical analysis employed SPSS version 26, considering p-values under 0.05 as significant. Results: RLS prevalence was 38.2% (95% CI: 31.4–45.4%). Multivariate regression identified age, hypertension, smoking (Odds Ratio = 2.98, p = 0.038), and longer ESRD duration as independent predictors of RLS. Furthermore, 81.6% of patients with RLS reported significant sleep disturbances, with 31.6% indicating extremely severe disruption. Conclusion: The prevalence of RLS among Iraqi hemodialysis patients is significantly high and is associated with poor sleep quality. Nursing-led screening and the application of non-pharmacological interventions may improve symptom management and overall outcomes.

Outcomes of Using Nursing Practice Guidelines for Prevention of Central Line-Associated Bloodstream Infections in Critically Ill Patients: A Comparative Study

Anucha Taiwong — 2026-04-02

Background: Central Line-Associated Bloodstream Infections (CLABSI) are a major complication in critically ill medical patients who receive central line catheter insertion. Therefore, Nursing Practice Guidelines (NPG) are needed. Objectives: This study aimed to compare the incidence of CLABSI between the intervention group and the standard care group. Methods: The research design was a comparative study. A total of 92 critically ill medical patients were recruited and assigned to the standard care group (n = 46), which received only standardized care, and the intervention group (n = 46), which received the NPG. The research instruments included: 1) the NPG for preventing CLABSI, 2) the patient data and clinical outcomes recording forms, 3) the nursing practice assessment forms, and 4) the satisfaction assessment forms. The research was conducted in the medical intensive care unit of a tertiary hospital. Data analysis was performed using descriptive statistics, Chi-Square tests, and relative risk ratio. Results: The intervention group had a CLABSI incidence rate of 0.48 per 1,000 C-line days, compared with 3.25 per 1,000 C-line days in the standard care group. Moreover, the intervention group reduced the risk of CLABSI by 89.5% (p <0.05). Professional nurses adhered correctly and comprehensively to the guidelines in over 80% of all components with high levels of satisfaction (M=4.58, SD=0.32). Conclusion: The findings suggest that consistent adherence to NPGs can substantially reduce preventable infections and improve patient safety.

Nurses’ Moral Competence in the Lens of Patients: A Qualitative Study

Roselyn Butalid — 2026-04-02

Background: Most studies that examined nurses’ moral competence were focused on the nurses’ own perspectives. Limited research exists on how patients perceive their nurses’ moral competence. To address this gap, this study explored the nurses’ moral competence as perceived by patients. Methods: This study employed a qualitative descriptive design, conducting in-depth interviews with 23 purposively selected ward patients from two hospitals in Iligan City, Philippines. Data were gathered using a researcher-made guide with open-ended questions, then recorded, transcribed, and thematically analyzed. Results: The moral competence of nurses is strongly reflected in their ability to provide patient-centered care demonstrated through compassionate support and responsiveness to patients’ needs. This is supported by ethically grounded clinical proficiency, combining effective communication, skilled task execution, autonomy preservation, and fairness. However, nurses face significant challenges such as Workload-Induced Burnout, Overlooking Harm Prevention, Irritability, Care Delays, and Compassion Fatigue, which hinder consistent moral practice and impact patient experiences. Conclusion: Nurses’ moral competence plays a crucial role in patients’ healthcare satisfaction; therefore, it is imperative to address personal and systemic barriers like burnout and compassion fatigue through manageable workloads and support programs. Integrating moral competence frameworks into nursing education and continuous professional development enhances ethical decision-making, communication skills, holistic care delivery, moral resilience, and stress management, thereby better equipping nurses to confront clinical challenges.

Emotional Intelligence and Quality of Life Among Women with Polycystic Ovary Syndrome: An Educational Program

Asmaa Abo Bakr Helmy — 2026-04-02

Background: Nurses are at the forefront of health care, who play a vital role in the care of women with polycystic ovary syndrome, providing education, support, and guidance to help them manage their condition and improve their quality of life. Women with Polycystic Ovary Syndrome (PCOS) often face challenges, such as infertility and sexual dysfunction, which can strain marital relationships and further reduce quality of life. Objective: Find out the impact of emotional intelligence educational program on quality of life among women with polycystic ovary syndrome. Methods: A randomized control trial (R.C.T). was applied. Total sample of 102 married women at the reproductive age (18-45) years old diagnosed with PCOs. For data collection, using three tools, a structure Interview questionnaire, quality of life tool and emotional Intelligence tool. First assessed and reevaluated after 6 and 12 months of providing the educational program to studied women which covering the theoretical and practical information. Results: The mean age in the study group was (30.61 ± 4.98) years old and control group was (32.06 ± 4.34) years old majority of women in both group have irregular menstruation (70.6%, 80.4%), there was highly statistically significance difference between control and study group in post-test and follow up (p-value =0.031, 0.001) respectively following program implementation, and there was positive correlation between quality of life and emotional intelligence. The quality of life of women is statistically significantly impacted by irregular menstruation and infertility pre, post and following program implementation. Conclusion: It was concluded that educational programs about emotional intelligence effectively improve the negative effect of PCO on women’s quality of life and have helpful influence in adverse domain of quality of life. Upgrading women’s knowledge toward lifestyle modification and enhancing service training program in the field of emotional intelligence for women and nurses.

A Comparative Analysis of Blended, Video-Based and Face-to-Face Learning Modalities for Mechanism of Labor among Nursing Students of Sikkim, India

Barkha Devi — 2026-03-24

Background: Effective teaching strategies are crucial for enhancing clinical competencies among nursing students. This study evaluated the effectiveness of blended learning, video-based learning, and face-to-face learning on the knowledge and skill acquisition related to the mechanism of labor among undergraduate nursing students. Methods: A quasi-experimental study with a pre-test and post-test design was conducted at Sikkim Manipal College of Nursing. Ninety-three third-year B.Sc. nursing students were selected through complete enumeration and randomly assigned to three groups (n=31 each): Group 1 (video-based learning), Group 2 (blended learning), and Group 3 (face-to-face learning as control). Knowledge was assessed using a structured questionnaire, and skill was evaluated using a rating scale. Post-tests were administered immediately after the intervention and on the 8^th and 28^th days. Data were analyzed using descriptive and inferential statistics, including ANOVA, paired t-tests, and chi-square tests. Results: All three teaching methods significantly improved students’ knowledge and skills (p < 0.001). The blended learning group showed the highest improvement in both knowledge (mean difference = 5.93) and skill scores (mean difference = 18.61), followed by face-to-face and video-based learning groups. No significant association was found between most demographic variables and post-test scores, except for age, which was significantly associated with skill performance in the blended group (p=0.020). Conclusion: Blended learning was the most effective teaching method for enhancing both theoretical knowledge and practical skills on the mechanism of labor among undergraduate nursing students. Integrating traditional and digital modalities offers superior educational outcomes and should be considered in nursing curricula.

Leadership in Nursing Management among Riau Malay Ethnicity and Nurses Educational Levels in the Hospital Wards

Ifon Driposwana Putra — 2026-04-02

Background: The head nurse plays a central role in coordinating ward activities and ensuring quality inpatient care. Leadership culture in nursing is shaped by individual and sociocultural factors, including educational background and ethnicity, which may influence leadership style and effectiveness. Understanding these influences is important for improving nursing management and patient outcomes. Objectives: This study examines the relationship between head nurses’ ethnicity, characteristics and educational background with perceived leadership effectiveness as evaluated by staff nurses in hospital wards. Methods: This study employed a quantitative cross sectional descriptive correlational design involving 240 nurses and 45 head nurses at a referral hospital in Riau Province, Indonesia. Head nurses provided demographic data, while staff nurses evaluated leadership effectiveness using standardized leadership questionnaires. Results: Over half (58%) of head nurses were of Riau Malay ethnicity, and most (84%) of the nursing staff expressed satisfaction with their leadership. The majority of head nurses were female (78%), in middle adulthood (87%), had over five years of experience (96%), and held professional nursing qualifications (71%). Inferential analysis showed that professional nursing education was significantly associated with higher leadership effectiveness scores (p = 0.003), while ethnic background showed no significant difference in leadership ratings across ethnic groups (p = 0.087). Conclusion: Leadership among Riau Malay head nurses is perceived positively across ethnic groups, reflecting cultural values that promote effective teamwork and patient satisfaction in nursing services.