The aim of this study was to develop a mobile application for patients with Type 2 diabetes initiating insulin therapy for the first time and to evaluate its effects on insulin knowledge, insulin injection skills, self-management of insulin therapy and attitudes towards insulin use. This randomized controlled study included 88 participants assigned by block randomization to intervention (mobile application, n = 44) and control (standard care, n = 44) groups. The intervention group received insulin training via the mobile app, whereas the control group received standard care. Data were collected at baseline (T1), on the 14th day (T2) and on the 28th day (T3) using the Patient Information Form, Insulin Knowledge Form, Insulin Treatment Assessment Scale, Insulin Treatment Self-Management Scale and Insulin Injection Skill Observation Form. In the intervention group using the mobile application, a statistically significant increase over time was observed in the levels of insulin-related knowledge, self-management of insulin treatment and insulin injection skills, whereas negative attitudes and perceptions regarding insulin treatment decreased (p < 0.05). No statistically significant change was observed in the control group (p > 0.05). The results obtained in the present study indicated that the mobile application developed for patients with Type 2 diabetes using insulin for the first time is effective in disease self-management, fosters positive behavioural changes and serves as a viable educational tool for individuals with Type 2 diabetes. The application can be integrated into routine nursing-led diabetes education programmes to enhance continuity of care and support patients during insulin initiation. ClinicalTrials.gov identifier: NCT06060743.

The study aimed to evaluate the effectiveness of information and communication technology interventions on mental health literacy among young adults and adolescents. The systematic review and meta-analysis methods were guided by the Cochrane guidelines for systematic reviews of interventions and the PRISMA guidelines. Included articles were evaluated with appraisal tools from the Joanna Briggs Institute. The authors searched nine databases to January 2026: PubMed, CINAHL, ERIC, EMBASE, ScienceDirect, Web of Science, Sociological Abstracts, PsycInfo and Scopus for relevant articles. A total of 55 articles were included in this review. The interventions were successful in enhancing mental health literacy (p < 0.001), recognition of mental health disorders (p < 0.001), stigma (p < 0.001), help-seeking attitudes/beliefs (p < 0.001) and intentions (p < 0.01). They were useful for improving personal stigma, social distance, self-stigmatisation of seeking help and stigmatising attitudes but not self-stigma, perceived stigma, stigmatisation by others for seeking-help, explicit attitudes and perception of dangerousness. The interventions were generally useful for improving mental health literacy. Interactive approaches such as websites, videos, and discussions were generally more effective than campaigns, games, applications, mere information or lectures.

Gastric retention is a common complication in enteral nutrition, which may lead to interruption of nutrition, malnutrition, electrolyte imbalance and other problems. Up-to-date knowledge of its incidence and influencing factors is crucial for optimal management strategies of enteral nutrition. This study aimed to conduct a systematic review and meta-analysis to quantify the incidence of retention of gastric contents in patients receiving enteral feeding and to identify significant influencing factors. This study is a systematic review and meta-analysis. Using established methods and searching from database inception to 18 May 2025, we searched CNKI, Wanfang Data, CBM, VIP, PubMed, Web of Science, EMBASE and The Cochrane Library. RevMan 5.4 software was used to perform the meta-analysis. A meta-analysis of 14 studies involving 2642 patients receiving enteral nutrition reported a 32.0% incidence of gastric retention. Nineteen factors associated with gastric retention were identified. Notably, descriptive analyses indicated that early initiation of enteral nutrition (OR = 0.37) and concomitant use of probiotics (OR = 0.22) were protective against the development of gastric retention. Findings support clinicians and nurses in more accurately identifying high-risk patients and formulating targeted intervention strategies based on the identified risk factors.

This study aimed to adapt the Reaper Oral Mucosa Pressure Injury Scale into Turkish and evaluate its reliability and validity for use by intensive care unit nurses in assessing oral mucosal membrane pressure injuries among intubated patients. A methodological study was conducted with 165 intensive care unit nurses in a tertiary hospital. The adaptation process followed international guidelines, including translation, back-translation, expert review and pilot testing. Psychometric testing included content validity, exploratory factor analysis, internal consistency and test-retest reliability. Although 83% of nurses reported familiarity with mucosal membrane pressure injuries, only 38% had received formal training, underscoring a practice gap. Turkish Reaper Oral Mucosa Pressure Injury Scale demonstrated strong psychometric performance: exploratory factor analysis confirmed a unidimensional structure (Kaiser-Meyer-Olkin = 0.92; Bartlett's χ2(136) = 2185.6, p < 0.001) explaining 52.4% of variance. Internal consistency was excellent (α = 0.874; full scale α = 0.94; item-total correlations 0.42-0.80). Turkish Reaper Oral Mucosa Pressure Injury Scale is a valid, reliable scale for oral mucosal membrane pressure injuries assessment.

This work aimed to translate the Perinatal Anxiety Screening Scale into Chinese and test its validity and reliability. Anxiety symptoms are common in the perinatal period and negatively affect maternal and fetal outcomes. However, a sensitive anxiety screening tool specific to perinatal women, including a broad range of problematic anxiety symptoms, is not available in the Chinese language. Based on the translation, adaptation and validation of instruments or scale guideline, the Chinese version of the Perinatal Anxiety Screening Scale was developed by translation, synthesis, back-translation, pilot testing and psychometric testing. By convenience sampling, 350 perinatal women participated in this study from a tertiary hospital in Guangzhou, China. The Chinese version of the Perinatal Anxiety Screening Scale comprised four dimensions with 31 items and demonstrated good internal consistency (Cronbach's α: 0.94) and acceptable test-retest reliability within a two-week interval (intraclass correlation coefficient: 0.81). An expert panel evaluated that the average Scale-Content Validity Index (S-CVI/Ave) was 0.96, and the Item Content Validity Index (I-CVI) ranged from 0.89 to 1.00. As expected, the PASS significantly correlated with the Pregnancy-specific Anxiety Questionnaire and Self-Rating Anxiety Scale (r = 0.74, p < 0.001; r = 0.67, p < 0.001). In exploratory factor analysis, the cumulative contribution rate of the four common factors was 66.19%. The PASS-C was rigorously developed following the translation, adaptation and validation guidelines. The PASS-C was evaluated to have good reliability and validity. Additionally, it was verified to be easy and fast to assess the severity of anxiety symptoms in perinatal women for clinicians in China. We therefore advise that the PASS-C be introduced into clinical practice as a rapid screening instrument of anxiety disorders in antenatal and postnatal women. This enables nurses or clinicians to initiate timely, evidence-based interventions, such as psychological support or referrals to mental health specialists, thereby improving maternal and infant outcomes.

This study aimed to compare the effect of using the Wondaleaf adhesive pouch (WLAP) barrier method on umbilical cord care to conventional antiseptic cord care. The study was a parallel randomized controlled study that involved a total of 234 term neonates, of which 117 were randomly assigned to both the test and control groups. The WLAP barrier method was used in the test group to protect the umbilical stump of the neonates after delivery. The control group received conventional antiseptic cord care. The cord was monitored daily until the stump detached in both groups and in the test group through the transparent pouch without dressing. The study found no incidence of omphalitis in either the test or control group. There was no statistically significant difference in cord separation time between the groups. However, male neonates in the test group but not the control group demonstrated a statistically significant but marginal delay in cord separation time compared with female neonates. The WLAP barrier method of umbilical cord care could successfully replace conventional antiseptic cord care with daily dressings without causing any infection or significant delay in cord separation time. More importantly, it provides a safe, protective and convenient approach to umbilical cord care.

This study was conducted to evaluate the effect of family planning education provided through online flashcards during the postpartum period on women's perceived barriers and attitudes. This study was conducted as a randomized controlled trial using the Solomon four-group design. The study sample consisted of 133 postpartum women who met the inclusion criteria and were recruited from the postpartum clinics (Intervention 1 = 33, Intervention 2 = 32, Control 1 = 33, Control 2 = 35). An online educational programme on contraceptive methods suitable for the breastfeeding period was delivered in the Intervention 1 and Intervention 2 groups via WhatsApp using digital flashcards. Three measurements were conducted for the Intervention 1 and Control 1 groups: a pretest before the education, a posttest immediately after the education and a follow-up posttest 1 month later. The other two groups did not undergo a pretest. The education provided through online flashcards resulted in a statistically significant change in the perceived barriers to contraceptive use and family planning attitude scores among women in the Intervention 1 group. The findings demonstrate that education delivered through online flashcards during the postpartum period positively influenced women's perceived barriers to contraceptive use and their attitudes toward family planning. These results suggest that online flashcards may serve as an effective and accessible educational tool to support family planning in the postpartum period. ClinicalTrials.gov identifier: NCT06052215.

To evaluate the effectiveness of the Smart Post-Discharge Elderly Health Management Platform on health-related quality of life and self-management after hospital discharge. The global aging population has increased challenges in post-discharge care for older adults, particularly due to chronic conditions and the need for continuous care. Cluster randomised controlled trial. The trial enrolled 383 elderly patients assigned to a platform-based intervention or standard telephone follow-up, with health-related quality of life, self-management, usability and economic outcomes assessed over 6 months. This study was reported in accordance with the CONSORT guidelines. Repeated measures analyses showed significantly greater improvements in HRQoL in the intervention group over 6 months (p = 0.026), with significant improvements across multiple physical and mental health domains (p = 0.002-0.021). Self-management total scores increased significantly (p < 0.001). Platform usability was rated highly by 96.35% of users, and 70.83% reported reduced healthcare costs. Providing a practical framework for integrating technology into nursing practice for aging populations, this platform shows promise for post-discharge elderly care by strengthening nurse-led digital health delivery, care continuity, self-management and health outcomes beyond hospital settings. ChiCTR2400089720.

This study aimed to synthesize evidence on multilevel strategies that promote nurse well-being and resilience to support workforce sustainability. Integrative review was guided by Whittemore and Knafl's methodology. Systematic searches of CINAHL, PubMed, Web of Science and MEDLINE identified 2485 records published between January 2002 and December 2025. After removing duplicates and screening titles and abstracts, 161 articles underwent full-text review. Sources addressing nurse well-being, burnout, resilience and mental health were assessed for eligibility. Study quality was appraised using the Johns Hopkins Evidence-Based Practice tool. Fifty-two primary research studies were retained for the results synthesis. Analysis revealed evidence organized within a three-pillar framework that integrates mental health promotion, burnout prevention and resilience building across individual, organizational and system levels. Unlike previous reviews focusing on single interventions, this framework shows that sustainable nurse well-being requires simultaneous, coordinated action across all three pillars. Evidence consistently identified adequate staffing, supportive leadership, and psychological safety as foundational enablers, with staffing adequacy showing the strongest associations with burnout reduction. Nurse well-being requires integrated, multilevel solutions that combine individual skill development with organizational reform and supportive policy environments to ensure workforce sustainability. This study provides actionable, evidence-based strategies for nursing leaders, educators and policymakers to foster healthy work environments that support nurse well-being, retention and quality patient care.

Nurses' understanding of radiation protection and their awareness of safety procedures are essential in reducing occupational exposure and maintaining a safe clinical environment. This study aims to examine how nurses' radiation protection knowledge and their level of safety awareness influence their safety behaviours. A cross-sectional correlational design was used. The study was conducted between June and August 2023 with 321 nurses employed in a hospital in the largest province of Türkiye. Data were collected using the Healthcare Professional Knowledge of Radiation Protection Scale, the Safety Awareness and Competence Scale and the Safety Behaviour Scale. Multiple linear regression analysis was performed to evaluate the predictive effects of radiation knowledge and safety awareness on safety behaviour. Nurses demonstrated low levels of radiation protection knowledge (3.29 ± 1.88), whereas their safety awareness was high (4.01 ± 0.65), and their safety behaviour scores were above average (3.70 ± 0.73). Safety behaviour showed a moderate positive correlation with radiation protection knowledge (r = 0.270, p < 0.001) and a strong positive correlation with safety awareness (r = 0.608, p < 0.001). Regression results demonstrated that both variables significantly predicted safety behaviour (R2 = 0.385, p < 0.001). Radiation protection knowledge and safety awareness together explained 38.5% of the variance in nurses' safety behaviour. These findings highlight the need for structured and continuous in-service training on radiation protection. In addition, institutional and national policies should be strengthened to support sustainable radiation protection practices in clinical settings.