Investigación y Educación en Enfermería

Embracing Artificial Intelligence (AI) in Nursing Education through Wearable Technology: Innovation-Driven Teaching

2025-07-27T16:11:58-05:00

Health Literacy in People with Diabetes: An Evolutionary Concept Analysis Using Rodgers' Approach

2025-07-27T17:08:32-05:00

Objective. To analyze the evolution of the concept of health literacy (HL) in people with diabetes mellitus (DM) according to the Rodgers approach.

Methods. The Rodgers approach was used, based on a scoping review that followed the steps of the JBI. Only methodologically clear studies that Only studies (articles) that clearly addressed HA in DM were included. Primary sources from health databases (e.g. PubMed, Scopus, Web of Science, SciELO, LILACS and BDENF) and grey literature (e.g. theses, dissertations and guides) were analysed via university repositories, Google Scholar, the Brazilian Digital Library of Theses and Dissertations and the CAPES Journal Portal (a Brazilian research support agency). The protocol was registered on the Open Science Framework (DOI: https://doi.org/10.17605/OSF.IO/Y2T3R).

Results. A total of 197 studies were selected, identifying seven key attributes of health literacy (HA): understanding, application, seeking, communication, critical appraisal, and sociocultural competencies related to diabetes. A total of 197 studies were selected to identify seven key attributes of health literacy (HA), such as understanding, application, seeking, communication, critical appraisal, and sociocultural competencies related to diabetes. Background factors (e.g., educational level and age) and outcomes (e.g., self-care, adherence, and glycemic control) were also examined.

Conclusion. HA has evolved from basic literacy to digital and multidimensional competence, which presents challenges in vulnerable populations. HA is essential for the autonomy and effective management of diabetes mellitus (DM), highlighting the need for personalized educational interventions, primarily in primary care.

Effectiveness of Acceptance and Commitment Therapy (ACT) in Mitigating Academic Procrastination and its Moderating Factors among nursing students

2025-07-29T10:32:27-05:00

Objective. To assess the effect of Acceptance and Commitment Therapy (ACT) on academic procrastination and its moderating factors among nursing students.

Methods. True experimental pre-test and post-test research design was adopted. The setting comprised of private nursing colleges of Punjab, India. A screening was done among 209 nursing students, 43 (20.57%) were procrastinators, which were assigned randomly to the intervention (n=19) and control (n=24) groups. The intervention was administered during six weeks, consisting of weekly one-hour modules that focused on the core components of ACT (Present Moment Contact, Defusion, Acceptance, Self as Context, Values, and: Commitment to Action). The effect of the intervention was measured after 6^th week through the scales: (i) Procrastination assessment Scale, (ii) Acceptance and action questionnaire-II (AAQ-II) and (iii) Student time management scale (STMS). A session of ACT was scheduled for the control group following the post-test. Study has been registered under Clinical Trail Registry of India (REF/2022/12/061719). Data was analysed using descriptive and inferential statistics.

Results. Post intervention assessment after 6 weeks revealed reduction in academic procrastination among the nursing students (mean difference -8.61, Standard error 0.35, p-value=0.01). Intervention also led to improvement in time management skills (mean difference 9.98, Standard error 0.32, p-value=0.001). Additionally, intervention results in improving psychological flexibility among the nursing students (mean difference -4.72, Standard error 0.49, p-value=0.02).

Conclusion. The study found ACT can reduce academic procrastination, and in the clinical setting, can and improve the time management, psychological flexibility among nursing students.

Dialectical nursing care: a concept analysis

2025-07-29T11:07:03-05:00

Objective. To analyze how the concept of dialectical nursing care is introduced in the scientific production of nursing.

Methods. It is a concept analysis based on Rodgers’ evolutionary model. An integrative literature review was carried out for the identification and selection of articles, in January 2022 and updated in March 2024, limited to the period between January 2010 and December 2023. The search was conducted in six databases: PubMed, Web of Science, Embase, Science Direct, Scopus and LILACS, combining the descriptors Dialectics, Health and Care.

Results. Based on Rodgers’ evolutionary model, it was possible to identify the attributes of the concept, which are: dialectical sensitivity, dialectical attitude, ambience and social determinants. The antecedents: The being and its social relationships, Health services, Work processes and Formative paradigm. The consequents: The being who cares for and the being cared for in their relationships, Work process and Formative paradigm.

Conclusion. This study contributed to the clarification of the concept that proposes the analysis of dialectics in the social production of illness and health, operating syntheses and new syntheses, in order to overcome the contradictions that historically cross people, macrostructure and area of nursing knowledge.

Educational intervention to prevent postoperative complications and improve functional outcomes in patients with transurethral resection of the prostate

2025-07-29T11:17:29-05:00

Objective. To assess the effectiveness of an educational intervention in reducing post-operative complications and improve functional outcome patients undergoing Transurethral Resection of the Prostate -TURP-.

Methods. A quasi-experimental nursing-led study (post-test only control design) was conducted among 60 TURP patients (intervention group n=30 and control group n=30). Face-to-face education on self-management strategies lasting 20-25 minutes, educational booklet and weekly telephone follow-up was administered to the intervention group; while control group received routine care. Data collection tool administered at 4th and 8th week post TURP included a post-operative checklist, IPSS (International Prostate Symptom Score), and IIEF (international index of erectile function).

Results. Urinary incontinence rates were considerably reduced in the experimental group at 4 weeks (p<0.001). Despite an 8-week reduction in differences, both groups Indicated effective care and no cases of trans-urethral resection syndrome or urinary tract infection. In the experimental group, IPSS scores were lower (9.9±4.6) than in the control group (15.6±5.8) indicating improved symptoms (p<0.001). Additionally, IIEF scores were higher in the experimental Group (3.5±1.2) than in the control group (2.6±1.2), suggesting improved erectile function with nurse-led intervention (p<0.004).

Conclusion. The nurse-led educational intervention effectively improves functional outcomes and reduce post-operative complications in Benign prostatic hyperplasia patients following TURP. Integrating such interventions by healthcare professionals can further accelerate recovery and minimize complications.

Knowledge, self-efficacy, satisfaction and self-confidence of nursing students for stoma care using active learning methodologies: a quasi-experimental study of three arms

2025-07-29T11:32:00-05:00

Objective. To assess knowledge about stoma care in relation to the level of learning methods and to measure students' self-confidence, satisfaction and self-efficacy with the training received using different learning methods including simulation.

Methods. A quasi-experimental study of three arms, with pretest and post-test design in third-year nursing students during the academic year 2022-2023. Group A received traditional teaching methods and low-fidelity simulation, group B received traditional teaching methods and high-fidelity simulation, and group C received active learning methods and high-fidelity simulation.

Results. Significant differences were found in 14 of the 15 NOC indicators measured between groups. Self-efficacy showed significant differences between the different groups (p<0.001) after the intervention. For satisfaction and self-confidence, there were significant differences (p<0.001) observed between the different fidelity groups).

Conclusion. This study found that simulation improved the level of knowledge regarding ostomies and had a positive impact on satisfaction and self-confidence in all three intervention groups, with significantly higher results among participants in Group C (active learning methods and high-fidelity simulation).

Impulsivity among Senior Nursing Students: The role of Emotional Intelligence and clinical performance

2025-07-29T12:14:28-05:00

Objective. This study examined the relationship between impulsivity, emotional intelligence, and clinical performance.

Methods. Through a total enumerative sampling technique, this correlational study involved 229 pre-final and final-year nursing students from Northern India. Data were collected using validated questionnaires measuring Emotional Intelligence -EI- (Schutte Self-Report Emotional Intelligence Scale), Barratt Impulsiveness Scale–Brief (BIS‑Brief), and clinical competence (Clinical Competence Questionnaire).

Results. All participants were nursing students, with 62% in their pre-final year; however, only 83.41% expressed interest in pursuing a nursing career. A significant negative correlation of impulsivity with self-awareness (r=-0.54, p=0.021) and advanced nursing skills (r=-0.61, p=0.031) was found. Among selected socio-demographic variables, age (p=0.049) emerged as a significant positive predictor of impulsive behaviour.

Conclusion. The findings suggest impulsivity is inversely related to self-awareness, a domain of EI, and advanced nursing skills, implying that students with higher self-awareness exhibit better emotional regulation and decision-making in clinical settings.

The Digital Shift in the Post-COVID Era: Evaluating the Impact of Web-Enabled Education on Cognitive, Affective, and Psychomotor Skill Enhancement in Gen ‘Z’ Nursing Students- A Systematic Review with meta-analysis.

2025-07-29T12:23:35-05:00

Objective. This study evaluates the impact of digital educational technologies on nursing students' academic achievement and learning outcomes.

Methods. A literature review was conducted to identify peer-reviewed articles published in English between 2020 and June 2024 in databases such as Web of Science, Science Direct, EBSCO, NLM/NIH/PMC and Scopus. This review compares the efficacy of digital educational interventions against control groups using Cochrane Collaboration's risk of bias (RoB) and Standardized Mean Difference (SMD) for outcome measurement, with results analyzed using RevMan Web.

Results. This study analyzed fourteen randomized controlled trials involving 1611 participants. The meta-analysis found that digital educational technologies enhanced nursing students' cognitive skills (SMD=0.45; p<0.001), critical thinking and clinical decision-making skills (SMD=0.88; p<0.001), attitudes (SMD=0.94; p<0.001), and clinical skills (SMD=1.09; p<0.001) when compared to conventional instructional methods. Nevertheless, there was no statistically significant improvement in the problem-solving ability (SMD=1.00, p=0.07).

Conclusion. Recent advances in digital technology provide a spectacular opportunity to improve healthcare practices for nurses and nursing students. Their integration can potentially increase educational and professional skills, quality of life, and patient satisfaction.

Pioneers in Care: The Incorporation of Men in Nursing in Spain and Great Britain (1915-1980)

2025-07-29T12:29:37-05:00

Objective. To describe the incorporation of the first male nurses in Spain and Great Britain between 1915 and 1980.

Methods. This study adopted the analytical-synthetic historical method as epistemological framework to examine the evolution of the appearance of the first male nurses in Spain and Great Britain, supported by documentary sources from databases (SCIELO, SCOPUS, EBSCO, Google Scholar) using descriptors in Spanish, English, and Portuguese. Historical critique was applied at three levels: authenticity, representativeness, and relevance. The analysis combined temporal and thematic perspectives, examining causal factors, such as economic, social, ideological factors.

Results. In Spain, nursing had segregated roles, women as nurses or midwives and men in the role of interns. In Great Britain, it was exclusively practiced by women. The Spanish Civil War and the dictatorship of Francisco Franco in Spain and the Second World War in Great Britain promoted male incorporation in both countries. The post-war periods and changes in gender roles facilitated a sociocultural transformation, integrating men into nursing and breaking stereotypes. This process redefined the profession, promoting equity and highlighting care beyond gender.

Conclusion. The historical study reveals that nursing in Spain and Great Britain evolved from an exclusive profession for women toward a more inclusive model, defying stereotypes. Wars and social changes permitted incorporating men, redefining the professional identity. This transformation does not seek to privilege, rather, it seeks to highlight equity and that regardless of the sex or gender care can be provided as long as it has a scientific and ethical basis.

How do annoying environmental stimuli affect cognitive failures and sleep quality in intensive care unit nurses? Mediating role of mood

2025-07-29T13:33:46-05:00

Objective. To investigate the relationship between disturbing environmental stimuli with sleep quality and cognitive failures in intensive care unit nurses, taking into account the mediating role of mood.

Methods. A cross-sectional study was done with the participation of 201 intensive care unit nurses who were selected by census method from public hospitals in western Iran. Questionnaires were used to collect data, including: pittsburgh sleep quality index (PSQI), occupational cognitive failure questionnaire (OCFQ), Brunel Mood Scale (BRUMS), environmental annoyance and perceived noise annoyance. Modeling was done with univariate linear regression and multivariate regression.

Results. The results of the study revealed that 84.1% of the participants had poor sleep quality. 13.3% experience cognitive failures at a low level, 61.7% at an average level, and 7% experience cognitive failures at a high level. By examining the mediating role of mood, it was found a significant and negative relationship between positive mood and: annoying environmental stimuli and people's positive mood (p=0.004) and noise annoyance (p=0.002); another significant and negative relationship was also observed between noice annoyance and cognitive failures (p<0.001).

Conclusion. Considering the mediating role of mood in the effect of environmental variables on cognitive failures and quality of sleep, it is recommended to use psychological interventions to adjust nurses' mood.

Incidence of Pressure Ulcers in Adults Hospitalized in Intensive Care Units in Colombia

2025-07-29T15:17:48-05:00

Objective. To estimate the incidence of pressure ulcers (PU) in hospitalized adults and its relationship with prevention practices in adult intensive care units (ICU) in Colombian hospitals.

Methods. This was a multicenter prospective cohort study in 31 non-COVID-19 ICUs from 11 hospitals in Colombia, including 1543 patients without ability to move, but with healthy skin, admitted consecutively upon admission to ICU. The primary outcome was the incidence of PU per 1,000 days of hospital stay.

Results. The participants were mostly men (57.5%), with mean age of 59±18 years and body mass index of 25.5±4.6 kg/m². The study observed 120 PU in 17 063 days of hospital stay, the majority were in the sacral region (60.0%) and heels (10.8%). Overall incidence was of 7.03 (95%CI 5.9-8.41) by 1000 days-patient. The PU incidence rate was double in ICUs of public hospitals than in private hospitals [Incidence Rate Ratio (IRR) = 2.00; 95%CI: 1.30 to 3.01]. The risk of pressure ulcers was lower in hospitals that had skin-care group (IRR = 0.38; 95%CI: 0.25 to 0.58), used dressings [IRR = 0.66; 95%CI: 0.45 to 0.95] and support surfaces [IRR = 0.37; 95%CI: 0.24 to 0.59] in their preventive care practices.

Conclusion. Much variability was noted in the PU incidence among the hospitals observed. However, Grade I and II ulcers and located in the sacral region continue having the highest incidence, according with global reference data. Hospital preventive care patterns reported a series of interventions administered in ICU that can be related with the risk of PU.

Relationship of Digital Game Addiction with Aggression and Anger in the Post COVID-19 Era: A Systematic Review and Meta-Analysis

2025-07-29T15:32:11-05:00

Objectives. To evaluate the relationship of digital gaming addiction with aggression and anger behavior among people.

Methods. This meta-analysis and systematic review was conducted using PRISMA and MOOSE guidelines to find articles in the databases PubMed, Scopus, Embase, and EBSCO. The evaluation comprised ten studies with 11,259 individuals. Researchers systematically extracted data on aggression, anger, and gaming addiction. The meta-analysis evaluated heterogeneity and pooled correlations using random-effects models. The study protocol was registered with PROSPERO under the registration number CRD42025642494.

Results. Addiction to digital games was found to be strongly correlated with aggression (r = 0.531, 95% CI [0.226, 0.836]) and moderately with anger (r = 0.348, 95% CI [0.177, 0.518]). Regional analysis revealed that Saudi Arabia study had the strongest correlation (β = 1.004, p<0.001), whereas Italy, Nepal, Singapore, and Turkey studies had comparatively lower correlations. Anger consequences were also found to be moderated correlations by age, with younger adolescents experiencing more negative consequences (β = -0.0696, p=0.049).

Conclusion. The meta-analysis demonstrates significant positive correlations between digital game addiction, aggression, and anger, highlighting the importance of nurse-led interventions in vulnerable groups in order to promote the reduction of the negative consequences of digital addiction.

Factors Influencing Clinical Competence Among Nursing Students: Exploring Emotional Intelligence and Sleep Quality

2025-07-29T15:43:37-05:00

Objective. This study aimed to investigate emotional intelligence (EI), sleep quality, and clinical competence among nursing students and identify factors associated with clinical competence.

Methods. This cross-sectional study included 199 pre-final and final-year nursing students from a college in Northern India. Data were collected using validated questionnaires measuring EI (Schutte Self-Report Emotional Intelligence Scale), sleep quality (Pittsburgh Sleep Quality Index), and clinical competence (Clinical Competence Questionnaire).

Results. Most students demonstrated high EI (56.3%) and good sleep quality (54.3%). EI was positively correlated with clinical competence (r=0.417, p<0.01) and negatively correlated with poor sleep quality (r=−0.173, p<0.05). Final-year students scored significantly higher on EI, clinical competence, and sleep disturbance than pre-final-year students. Multiple regression analysis identified academic year (β=0.208, p=0.002), EI (β=0.248, p<0.001), and sleep disturbance (β=−0.188, p=0.004) as significant predictors of clinical competence.

Conclusion. EI and sleep quality are important factors associated with the clinical competence of nursing students. Incorporating EI training and sleep hygiene education into nursing curricula may help improve students' clinical performance and prepare them for professional practice.

Factors related to self-medication in undergraduate nursing students: a scoping review

2025-07-29T12:03:58-05:00

Objective: The aim of this study was to map and summarize the extent and type of evidence related to self-medication among undergraduate nursing students.

Method: A scoping review was conducted in accordance with the guidelines of the Joanna Briggs Institute. The guiding questions of the interviews were the following: 1) "What are the reasons/motivations and health conditions leading to self-medication behavior in nursing students?"; 2) "What are the sources of information involved in the decision-making process for self-medication?"; 3) "What medications are used in self-medication?"; 4) "What are the perceptions of risks and benefits of this behavior?"; 5) "What are the knowledge, beliefs/attitudes, and practices regarding self-medication?" The descriptors used were: "self-medication" AND "students, nursing" combined with their synonyms. A total of 55 articles were included from searches in the MEDLINE, Web of Science, Scopus, and Virtual Health Library databases, including gray literature.

Results: The analysis of the studies resulted in ten categories characterizing the factors of self-medication: clinical conditions (n=52), reasons/motives (n=54), recall period (n=22), drug classes (n=54), sources of advice (n=53), perception of risks (n=47) and benefits (n=21), knowledge (n=27), beliefs and attitudes (n=27), and practices (n=20).

Conclusion: This study showed that clinical, socioeconomic, and behavioral factors are common themes described in the literature on self-medication among undergraduate nursing students. There are opportunities, especially in training, to improve self-medication practices and patient safety among future nurses.