Category: Nevin Manimala

Nurs Open. 2026 Sep;13(9):e70739. doi: 10.1002/nop2.70739.

ABSTRACT

AIM: To examine whether recovery experiences and need for recovery mediate the association between psychological capital and perceived stress in nurses.

DESIGN: Cross-sectional online survey.

METHODS: A total of 184 nurses currently practicing in France completed an anonymous online questionnaire administered in January 2023. Participants completed the French versions of the Psychological Capital Questionnaire, the Recovery Experience Scale, the Need for Recovery Scale, and the Perceived Stress Scale. Two mediation models were estimated using ordinary least squares regression with percentile bootstrap inference for the indirect effects.

RESULTS: Psychological capital was positively associated with recovery experiences and negatively associated with need for recovery. Need for recovery was strongly and positively associated with perceived stress, while psychological capital showed no direct association with perceived stress. The indirect effect of psychological capital on perceived stress through need for recovery was statistically detectable, whereas a complementary indirect effect through recovery experiences was in the expected direction but did not meet the bootstrap criterion for statistical significance.

CONCLUSION: In this cross-sectional sample, psychological capital was associated with lower perceived stress primarily through its association with reduced need for recovery rather than through a direct association with stress. Interventions intended to protect nurse well-being should therefore be conceived as combining individual resource-building with organizational architectures that enable effective recovery.

IMPLICATION FOR NURSING PRACTICE: Psychological capital should be seen as one element in integrated interventions rather than a stand-alone solution to nursing stress. Brief recovery-focused interventions for nurses need to be combined with scheduling practices and organizational policies that protect rest and make recovery feasible, a configuration that appears more promising than psychological capital training alone.

REPORTING METHOD: The study followed the STROBE Statement for the reporting of cross-sectional studies.

NO PATIENT OR PUBLIC CONTRIBUTION: This study focused on nurses as study participants. No patient or public stakeholder was involved in the design, conduct, or interpretation of the research, since the research question concerns occupational psychological resources rather than clinical practice or care delivery.

PMID:42669211 | DOI:10.1002/nop2.70739

Nurs Open. 2026 Sep;13(9):e70781. doi: 10.1002/nop2.70781.

ABSTRACT

AIMS: To examine the associations among illness perception, resignation coping, social support, and self-regulatory fatigue (SRF) in patients with Type 2 diabetes mellitus. The study specifically explores whether resignation coping and social support exhibit indirect associations with SRF in the context of illness perception.

DESIGN: A cross-sectional study.

METHODS: From November 2024 to October 2025, a convenience sample of 302 adult patients with T2DM was recruited from a tertiary general hospital in China. Participants completed validated instruments with established psychometric properties, namely the Brief Illness Perception Questionnaire, the Medical Coping Modes Questionnaire, the Perceived Social Support Scale, and the Self-Regulatory Fatigue Scale. Statistical analyses included Spearman correlation and serial mediation analysis using the PROCESS Macro (Model 6) with bias-corrected bootstrapping.

RESULTS: SRF was positively correlated with negative illness perception (r = 0.579, p < 0.01) and resignation coping (r = 0.612, p < 0.01), and negatively correlated with social support (r = -0.598, p < 0.01). Serial mediation analysis revealed that illness perception was associated with SRF through indirect pathways involving resignation coping and social support. Resignation coping and social support mediated the association between illness perception and self-regulatory fatigue, both individually and sequentially.

CONCLUSIONS: Negative illness perception correlates with higher SRF. This observed correlation is additionally linked to indirect pathways involving resignation coping and lower social support. Collectively, these findings highlight a pattern of interrelated cognitive (illness perception), behavioural (resignation coping), and resource (social support) factors that are associated with self-regulatory fatigue in this cross-sectional study.

IMPLICATIONS FOR THE PROFESSION: The findings offer a clear, evidence-based framework for nursing practice. They highlight the potential value of integrated assessment and intervention that simultaneously addresses patients’ illness beliefs, maladaptive coping strategies, and social support systems, which are associated with lower SRF and better diabetes self-management.

REPORTING METHOD: This study adheres to the Strengthening the Reporting of Observational Studies in Epidemiology (STROBE) guidelines for cross-sectional studies.

PATIENT OR PUBLIC CONTRIBUTION: Patients participated solely as research participants by providing survey data. They were not involved in the study design, implementation, data analysis, interpretation, or manuscript preparation. All patients provided written informed consent prior to questionnaire completion.

PMID:42669206 | DOI:10.1002/nop2.70781

Nurs Open. 2026 Sep;13(9):e70757. doi: 10.1002/nop2.70757.

ABSTRACT

AIM: This study aims to explore the experiences, strengths, challenges, and potential improvements for professionals in managing the complex needs of vulnerable migrants (VM) in an Italian rural reception centre.

METHODS: A qualitative study using semi-structured interviews was conducted in April 2024. Data were analysed using the Automatic Analysis of Textual Data, based on Fraire’s seven-step model for Exploratory Multidimensional Data Analysis.

DATA SOURCES: Data were collected from 16 professionals working in a rural reception centre in southern Italy. Interviews were conducted and analysed using AATD in April 2024.

FINDINGS: The analysis identified two main dimensions of professionals’ roles: balancing systemic responsibilities with personal engagement and managing immediate needs versus long-term integration goals. Professionals face significant challenges, such as resource scarcity, bureaucratic inefficiencies, and emotional fatigue, which impact their well-being and the quality of care provided to migrants. Resilience, adaptability, and multidisciplinary collaboration were identified as key strengths.

CONCLUSION: The study highlights the dual nature of professionals’ work in reception centres, requiring them to balance operational tasks with emotional involvement in migrant care. Targeted interventions and systemic reforms are necessary to support professionals and enhance the quality of care for vulnerable migrants, particularly in resource-constrained rural settings.

IMPLICATIONS FOR PRACTICE AND/OR PATIENT CARE: This study underscores the importance of providing targeted support to professionals working in reception centres, including training in intercultural competence, stress management, and coping strategies. Policies should address systemic challenges and provide resources to enhance healthcare delivery and social integration programs.

REPORTING METHOD: This study adhered to the EQUATOR guidelines for reporting qualitative research (COREQ). The findings were reported in compliance with these guidelines, ensuring methodological rigour and transparency.

PATIENT OR PUBLIC CONTRIBUTION: No patient or public contribution.

IMPLICATIONS FOR THE PROFESSION AND/OR PATIENT CARE: This study highlights the critical need for targeted support and training for professionals working in reception centres, particularly in rural settings. To improve care for vulnerable migrants, professionals should receive training in intercultural competence, stress management, and coping strategies to better navigate the complex challenges they face. Furthermore, systemic changes are necessary to alleviate the pressures on reception centres, such as streamlining bureaucratic processes and enhancing healthcare infrastructure, particularly in rural areas where resources are limited. By addressing these needs, we can improve the well-being of both the professionals and the migrants they serve, fostering more effective support systems and better care outcomes. Additionally, fostering multidisciplinary collaboration and community engagement can contribute to more comprehensive and sustainable care models.

PROTOCOL REGISTRATION: The Ethics Committee of the University of Rome Tor Vergata approved this study on 07/07/2021 (protocol registration number 160.21).

PMID:42669202 | DOI:10.1002/nop2.70757

Nurs Open. 2026 Sep;13(9):e70780. doi: 10.1002/nop2.70780.

ABSTRACT

AIM: The primary duties of emergency healthcare professionals (EHPs) are to provide emergency patient care to acutely ill and injured individuals. Due to the nature of their work, EHPs operate under constant stress, often requiring rapid decision-making, swift action, and the delivery of necessary medical care in life-or-death situations, sometimes under inadequately safe conditions. Therefore, the aim of this study is to determine the validity and reliability of the Emergency Healthcare Professional Stress Factors and Symptoms (SEHP:SFMS) Scale in Turkish for identifying stress factors and symptoms in emergency medical care professionals providing emergency patient care services.

DESIGN: A methodological study design was used in this study.

METHODS: The study was conducted with the participation of 211 EHPs from employees working in emergency care institutions affiliated with the Muğla Provincial Health Directorate between November 2023 and June 2024. Data were collected via a face-to-face survey. Data were analysed using Lawshe content validity ratio, Kaiser-Meyer-Olkin coefficient, Bartlett test, exploratory factor analysis, principal component analysis, Varimax factor rotation method, confirmatory factor analysis, Cronbach’s α internal consistency coefficient, convergent validity, discriminant validity, test-retest, and Spearman correlation coefficient tests.

RESULTS: The linguistic translation and cultural adaptation of the SEHP:SFMS showed strong performance. The scope validity index of the scale is 0.83. The item-total correlation values of the scale were found to be between 0.486 and 0.794, and the factor loadings were between 0.474 and 0.816. Confirmatory factor analysis fit indices: χ² = 248.727; df = 101; n = 211; p = 0.000; χ²/df = 2.463; RMSEA = 0.083; CFI = 0.914, SRMR = 0.052, which was found to be compatible and acceptable with the proposed 3-factor model. The Cronbach’s α reliability coefficient of the scale was 0.931, and the total variance was 61.97%.

CONCLUSIONS: SEHP:SFMS is a valid and reliable tool to assess stress factors and symptoms of Turkish emergency healthcare professionals. Its use improves the quality of emergency care.

PATIENT OR PUBLIC CONTRIBUTION: These study findings have been used to create a tool with Turkish validity and reliability that allows for the examination of stress factors among healthcare professionals working in emergency and critical services. Identifying and reducing stress factors among healthcare professionals is crucial for the delivery of quality healthcare services. It can also be used to develop targeted interventions and ongoing strategies to facilitate improved clinical supervision and mentoring.

IMPLICATION FOR NURSING PRACTICE: Nurses in emergency departments, which are among the most stressful, dynamic, intense, life-saving, and critical environments in healthcare institutions, and where life-saving treatment is administered, are at high risk of experiencing psychological trauma. Trauma experienced in the work environment is a significant problem for nursing. The consequences of trauma negatively affect nurses and institutions. Studies show that post-traumatic stress, anxiety, depression, and burnout are commonly observed in emergency department nurses. In this sense, understanding the stress and stress factors experienced by nurses can guide future interventions. The results of this study are considered important in making visible the stress and stress factors experienced by nurses in the emergency department, and also in guiding managers and nurses working in this field in terms of preventive and protective measures.

PMID:42669199 | DOI:10.1002/nop2.70780

Nurs Open. 2026 Sep;13(9):e70790. doi: 10.1002/nop2.70790.

ABSTRACT

AIM: This cross-sectional study examined the associations between short video exposure, nursing students’ empathy, and attitudes toward end-of-life (EOL) care, and tested whether perceived impact is statistically consistent with an indirect pathway in these relationships.

DESIGN: A descriptive cross-sectional study.

METHODS: In total, 534 undergraduate nursing students were included. Data were collected using a self-designed questionnaire, including the Attitudes Toward Care of the Dying Scale and the Jefferson Scale of Empathy-Health Professions Student version for empathy assessment. Statistical analysis for correlation and mediation analysis (PROCESS macro) was performed.

RESULTS: 85.96% of students watch short videos for more than 30 min daily, with more than 60% of them viewing EOL-related content. Students with prior caregiving experience or formal palliative care education showed significantly higher empathy and more positive attitudes (p < 0.05). Exposure to medical and EOL-related short videos was positively correlated with perceived impact, empathy, and positive EOL attitudes, with effect sizes ranging from very weak to modest (r = 0.10 to 0.27). The data were consistent with an indirect pathway between short video exposure and empathy via perceived impact (indirect effect = 0.04; 95% bootstrap CI [0.01, 0.08]). However, for EOL attitudes, short video exposure showed a direct association rather than an indirect pathway via perceived impact (direct effect = 0.09, p < 0.01).

CONCLUSION: In this cross-sectional study, short video exposure was modestly associated with nursing students’ empathy, with data consistent with an indirect pathway via perceived impact; the observed associations explained only approximately 1% to 7% of the variance in the outcome variables. However, reshaping EOL attitudes may require more systematic education beyond brief video exposure. These findings are hypothesis-generating and await validation through longitudinal and experimental research using standardized video content.

IMPLICATIONS FOR NURSING PRACTICE: Nursing educators should consider integrating curated short video content into palliative care curricula to enhance students’ empathy and perceived impact of end-of-life education. However, brief video exposure alone may be insufficient to reshape deeper end-of-life attitudes, suggesting the need for comprehensive, multi-modal educational strategies.

PMID:42669195 | DOI:10.1002/nop2.70790

Nurs Inq. 2026 Oct;33(4):e70163. doi: 10.1111/nin.70163.

ABSTRACT

Contemporary nursing research increasingly generates large and complex textual corpora from interviews, open-ended surveys, clinical documentation, policy discourse and professional narratives. Although these materials contain rich representations of professional reasoning, organisational dynamics and patient experiences, their analysis remains largely confined to thematic qualitative approaches or variable-based quantitative models, which may struggle to examine how meanings are organised across extensive corpora. This article introduces the Multidimensional Interpretative Textual (MIT) design as an epistemological and methodological framework for corpus-based discourse analysis in nursing research, rather than a specific analytical technique or software procedure. The MIT design conceptualises discourse as a structured empirical object and examines textual data at the corpus level. By integrating multidimensional statistical formalisation with interpretive reasoning, it renders patterns in the organisation of meanings empirically observable before theoretical significance is attributed to them. The article outlines the design’s epistemological foundations, analytical object and research logic and proposes principles of methodological rigour, including analytical-interpretive separation, corpus structural adequacy, procedural traceability, interpretive arguability, structural-interpretive proportionality and theoretical interpretive transferability. The MIT design thus provides nursing science with a coherent research architecture for examining and comparing recurring patterns of meaning, professional reasoning and organisational logics across empirical contexts.

PMID:42669188 | DOI:10.1111/nin.70163

Curr Med Res Opin. 2026 Aug 30:1-9. doi: 10.1080/03007995.2026.2722388. Online ahead of print.

ABSTRACT

OBJECTIVE: To evaluate whether sublingual immunotherapy (SLIT) for Japanese cedar pollinosis is associated with subsequent initiation of antidepressants, and to assess its clinical implications for mental health management in real-world clinical practice.

METHODS: We conducted a retrospective real-world cohort study using a large nationwide administrative claims database in Japan from 2014 to 2021. Adult patients diagnosed with Japanese cedar pollinosis were identified and classified as SLIT users or non-users using a new-user design. Propensity score matching was performed to balance patients’ baseline characteristics, including age, sex, insurance type, and medical history. The primary outcome was initiation of antidepressant prescriptions. Hazard ratios were estimated using matched cohorts.

RESULTS: A total of 4,126 SLIT users and 88,455 non-users were identified, with 3,991 propensity-matched patients in each group. Before matching, mental disorders were more prevalent among SLIT users than among non-users, whereas allergic rhinitis severity was similar between groups. Crude initiation rates of antidepressants were 5.0 and 2.9 per 1,000 person-years among SLIT users and non-users, respectively. After matching, no statistically significant association was observed between SLIT use and antidepressant initiation (hazard ratio = 1.11, 95% confidence interval = 0.73-1.69). Kaplan-Meier analysis also showed no significant between-group differences.

CONCLUSION: No statistically significant association was observed between SLIT for Japanese cedar pollinosis and antidepressant initiation. These findings suggest that mental health outcomes should continue to be monitored independently of immunotherapy use in routine clinical practice. Further adequately powered studies with longer follow-up periods are warranted to better characterize depressive outcomes in this population.

PMID:42669179 | DOI:10.1080/03007995.2026.2722388

Curr Opin Ophthalmol. 2026 Aug 6. doi: 10.1097/ICU.0000000000001242. Online ahead of print.

ABSTRACT

PURPOSE OF REVIEW: Corticosteroid-sparing immunosuppression is standard for chronic noninfectious uveitis, yet its long-term safety remains a dominant clinical concern. We synthesize the contemporary evidence on long-term safety, common adverse effects that drive treatment discontinuation, and how those effects are managed across various medication classes.

RECENT FINDINGS: The largest cohort data show no statistically significant excess in overall or cancer mortality for antimetabolites, calcineurin inhibitors, or antitumor necrosis factor agents, whereas alkylating agents remain the principal malignancy concern. Discontinuation for toxicity is modest across classes and is usually driven by reversible, organ-specific effects: most often gastrointestinal intolerance for antimetabolites, nephrotoxicity for calcineurin inhibitors, and cytopenia for alkylating agents. Long-term data led by a 7-year adalimumab extension showed no new safety signals, with infection and tuberculosis reactivation as the main risks of tumor necrosis factor blockade.

SUMMARY: Steroid-sparing agents appear to have excellent long-term safety when the agent is matched to disease severity and patients are screened and monitored proactively. The safest agent is the one whose specific toxicity is anticipated and managed.

PMID:42669172 | DOI:10.1097/ICU.0000000000001242

Arthroscopy. 2026 Aug 30. doi: 10.1002/arj.70479. Online ahead of print.

ABSTRACT

PURPOSE: To perform a systematic review investigating the relation between improvements in patient-reported outcomes and range of motion with changes in acromiohumeral interval (AHI) after rotator cuff repair (RCR), tendon transfer (TT), and superior capsular reconstruction (SCR) for massive or irreparable rotator cuff tears.

METHODS: A literature search was performed using 3 databases from inception to December 2023 according to the 2020 Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. Human clinical studies reporting changes in AHI after RCR, SCR, and TT for massive or irreparable rotator cuff tears were included. A qualitative comparison across studies that reported either statistically significant improvement or no significant improvement in AHI to patient-reported outcomes and range of motion was conducted. Study quality was assessed using the Cochrane Collaboration’s risk of bias tool and the Methodological Index for Non-Randomized Studies criteria.

RESULTS: Forty-two studies including 1868 patients (362 RCR, 1101 SCR, and 405 TT) across 60 individual cohorts (10 RCR, 39 SCR, and 11 TT) were identified. Forty-four cohorts (8 RCR, 31 SCR, and 5 TT) representing 1374 patients noted a statistically significant improvement in AHI ranging from 0.40 to 5.3 mm. Sixteen cohorts (2 RCR, 8 SCR, and 6 TT) representing 494 patients noted no statistically significant improvement in AHI ranging from -3.2 to 0.7 mm. The mean improvement from baseline to final follow-up across American Shoulder and Elbow Surgeons, University of California-Los Angles, Visual Analog Scale Pain, and Constant scores in addition to forward flexion were comparable across both groups.

CONCLUSIONS: Improvements in functional outcome measures and forward flexion after soft tissue reconstruction for massive or irreparable rotator cuff tears are observed regardless of whether the AHI increases significantly from baseline.

LEVEL OF EVIDENCE: Level IV, systematic review of Level II to IV studies.

PMID:42669158 | DOI:10.1002/arj.70479

Public Health Rep. 2026 Aug 30:333549261467293. doi: 10.1177/00333549261467293. Online ahead of print.

ABSTRACT

OBJECTIVES: Most people with opioid use disorder (OUD) do not receive effective treatments despite their existence. The OUD cascade of care framework can be used to inform quality improvement efforts to address this gap, but data access and linkage requirements may limit its use. We sought to adapt the framework under the constraints of electronic health record data and identify patient populations at risk for OUD treatment discontinuity.

MATERIALS AND METHODS: We extracted data on patients with OUD from the Los Angeles County Department of Health Services from July 2022 through June 2023. We adapted the cascade of care to include probable OUD diagnosis, receipt of naloxone prescription, and receipt of ≥1 and ≥2 buprenorphine prescriptions. We then stratified and conducted statistical analyses for associations by sex, race and ethnicity, and facility type (inpatient, primary care, emergency, or urgent care).

RESULTS: Of 3881 patients identified with probable OUD, 49% received a naloxone prescription and 30% and 17% had ≥1 and ≥2 buprenorphine prescriptions, respectively, in 1 year. Non-Hispanic Black and Hispanic patients were less likely to receive buprenorphine prescriptions than were non-Hispanic White patients and patients of other or unknown race and ethnicity. We observed larger gaps in care between receipt of ≥1 and ≥2 buprenorphine prescriptions for patients using urgent care and emergency departments compared with patients in other settings.

PRACTICE IMPLICATIONS: This study illustrates substantial gaps between OUD diagnosis and treatment. This adapted framework for the OUD cascade of care can serve as a quality-monitoring tool to aid clinicians and health care administrators in narrowing the treatment gap for people with OUD.

PMID:42669155 | DOI:10.1177/00333549261467293