Background: Legal literacy is an essential yet underdeveloped domain in Philippine nursing education. Despite the increasing complexity of healthcare, undergraduate curricula offer limited structured training in legal knowledge and its clinical application, posing potential risks to both practitioners and patients.Purpose: This study aimed to develop and validate a structural model of legal literacy among Filipino nursing students, focusing on the influence of legal education exposure, perceived importance of legal knowledge, and confidence in legal application.Methods: This cross-sectional study employed purposive sampling and involved 300 undergraduate nursing students from multiple institutions. Legal literacy was conceptualized as nurses’ capacity to understand and apply medico-legal principles in clinical decision-making and patient advocacy. Data were analyzed using Partial Least Squares Structural Equation Modeling (PLS-SEM). The findings highlight that, beyond statistical relationships, valuing legal knowledge and developing confidence in its application are critical to preparing nursing students for legally sound and safe practice, underscoring important implications for nursing education and curriculum design.Results: All constructs demonstrated high reliability (CR > 0.93) and convergent validity (AVE > 0.76). Legal literacy (LL) was significantly predicted by perceived importance of legal knowledge (β = 0.389, p < .001) and confidence in legal application (β = 0.256, p < .001). Confidence also mediated the relationship between perceived importance and legal literacy (β = 0.057, p = .013). Legal education exposure influenced LL indirectly via perceived importance (β = −0.118, p = .003). The model explained 84.0% of the variance in LL. Model fit indices (SRMR = 0.042; Q² > 0.49) confirmed strong predictive relevance. Moderation by year level was not statistically significant.Conclusion: This study proposes a validated model of legal literacy that underscores the importance of both attitudinal valuation and application confidence. Integrating legal education with experiential learning and self-efficacy can enhance legal readiness among nursing graduates.

Background: Abuse of older adults is a global public health concern and can be viewed as any action that undermines the dignity and respect to which older individuals are entitled, with significant cultural connotations. Existing research on older adult abuse and neglect has predominantly focused on developed countries, leaving a paucity of empirical evidence from developing contexts such as Nigeria.Purpose: This study explored the perception of abuse among older adults, its various forms, and the extent to which older people experience abuse.Methods: A phenomenological study was conducted among 18 older adults residing in Ifedore Local Government Area of Ondo State, Nigeria, selected through purposive sampling. Data were collected through in-depth interviews using an interview guide with open-ended questions and were analysed using content analysis.Results: The findings uncovered four themes representing the types of abuse commonly experienced by older adults. These include: (i) distress caused by the sensual conduct of the younger generation; (ii) assault and neglect; (iii) deprivation of rights and access to property; and (iv) structural/institutional abuse by governmental agencies.Conclusion: This study showed that elder abuse manifests in multiple forms, including physical, emotional, financial, sexual, neglect, and structural/institutional abuse, which are often rooted in sociocultural practices, economic hardships, and systemic failures. Therefore, measures should be put in place to protect the rights of older adults. In addition, prevention and early detection of abuse should be given priority to make ageing a pleasurable rather than an agonising experience for older adults.

Background: Women with high-risk pregnancies following infertility are vulnerable to anxiety, which may contribute to adverse pregnancy outcomes and impaired prenatal attachment. While previous studies have examined anxiety in infertility or high-risk pregnancy separately, limited evidence exists on theory-based nursing interventions that integrate both conditions to support maternal role attainment. This study addresses this gap by applying an integrated nursing model based on King’s Goal Attainment Theory and Mercer’s Becoming a Mother Theory.Purpose: To describe how King’s Goal Attainment Theory and Mercer’s Becoming a Mother Theory are operationalized within the nursing care process to support maternal role attainment in women with high-risk pregnancies following infertility.Methods: This case series applied Goal Attainment Theory and Becoming a Mother Theory in the nursing care of five women. A seven-day intervention was provided to support encoding into long-term memory. Participants were pregnant women with a history of infertility who achieved natural conception and presented with high-risk conditions. Goal Attainment Theory facilitated interactive communication to achieve mutual goals, while Becoming a Mother Theory guided support for maternal role attainment.Results: Participants demonstrated adequate knowledge and strong commitment to pregnancy care but experienced psychosocial challenges, suboptimal prenatal attachment, and limited preparation for childbearing. Theory-based nursing care grounded in King’s Goal Attainment Theory and Mercer’s Becoming a Mother framework actively engaged clients in problem identification, goal setting, and collaborative care planning, thereby enhancing understanding of health conditions, reducing anxiety, strengthening commitment to prenatal care, and improving prenatal attachment across cases.Conclusion: Clients’ participation supports maternal adaptation and role attainment during pregnancy. Integrating Goal Attainment and Becoming a Mother Theory offers a practical and person-centered framework for women with high-risk pregnancies following infertility. The findings emphasize the importance of shared goal-setting and interactive communication. Further research with a larger sample is needed to confirm broader applicability.

Background: Problematic smartphone use among nursing students has been linked to impaired learning and professional performance. While previous research has primarily focused on addictive or compulsive smartphone use, limited attention has been paid to individuals’ intentional and reflective efforts to regulate their smartphone use. Moreover, no validated instrument exists to assess reflective smartphone disengagement among nursing students in the Turkish context.Purpose: This study aimed to adapt and validate the Turkish version of the Reflective Smartphone Disengagement Scale among undergraduate nursing students.Methods: A descriptive, cross-sectional design was employed at a nursing faculty in a public university in the southern region of Türkiye. Using convenience sampling, the study included 376 undergraduate nursing students from all grade levels who owned a smartphone and consented to participate. Sample size adequacy was supported by recommended item-to-participant ratios and an acceptable KMO value. Data were collected using a personal information form, the Reflective Smartphone Disengagement Scale, and the Nomophobia Questionnaire. Face, content, construct, and criterion validity procedures were applied for scale adaptation.Results: Exploratory Factor Analysis (EFA) revealed that the Turkish version of the Reflective Smartphone Disengagement Scale has a two-factor structure with six items, comprising usage moderation (items related to limiting smartphone use across specific times, places, situations, and life balance) and availability management (items related to controlling reachability and intentional disconnection). Internal consistency was acceptable, with Cronbach’s alpha coefficients of .70 and .81, respectively. Confirmatory Factor Analysis indicated a good model fit (CFI = .97, RMSEA = .08).Conclusion: The Turkish version of the Reflective Smartphone Disengagement Scale is a valid and reliable tool for assessing nursing students’ conscious efforts to manage smartphone use and can be utilized in nursing education to identify students’ self-regulatory behaviors and inform interventions aimed at promoting healthy smartphone use in academic and clinical settings.

Background: Maternal and child health (MCH) is crucial for public health, especially in low- and middle-income countries like Indonesia. Despite improvements in healthcare infrastructure, challenges remain in reducing maternal and neonatal mortality rates, with low birth weight (LBW) posing a significant concern. Previous research has largely examined individual factors, such as maternal age, parity, or nutritional status, in isolation. To date, there has been no comprehensive analysis integrating the various determinants of LBW within the Indonesian context.Purpose: This study aimed to comprehensively analyze factors associated with LBW incidence in Indonesia to inform sustainable MCH strategies.Methods: A cross-sectional study design was used to analyze data from 420 newborns and their mothers. A structured questionnaire and medical record reviews were used to collect data on maternal characteristics, antenatal care attendance, birth outcomes, and infant characteristics. Data were obtained from maternal and child health reports collected by primary health centers and hospitals under the Ministry of Health between 2021 and 2023. Statistical analyses, including bivariate Chi-square tests and multivariable logistic regression, were conducted to identify factors associated with LBW incidence.Results: The prevalence of LBW among newborns was 34.3%. Significant associations were found between LBW and maternal anemia (OR = 1.53; 95% CI = 1.16–2.03), irregular antenatal care attendance (OR 11.9; 95% CI 8.17–17.32), multiparity (OR = 0.61; 95% CI = 0.43–0.88), and preterm birth (OR = 11.22; 95% CI = 7.55–16.68). Primiparous mothers and full-term infants were less likely to experience LBW. Among the associated factors, irregular antenatal care visits and preterm birth emerged as the most dominant risk factors. No significant associations were observed with maternal complications, chronic diseases, infant gender, mode of delivery, or maternal age.Conclusion: Targeted interventions addressing maternal anemia, improving access to and adherence with antenatal care, and preventing preterm births are critical strategies for reducing LBW in Indonesia. The findings in this study underscore the need to improve maternal nutrition and encourage pregnant women to attend regular antenatal care visits.

Background: Cesarean section (CS) delivery should only be performed when medically indicated. However, socioeconomic disparities continue to influence CS utilization in many countries, including the Philippines. Although previous studies have examined CS rates, there is limited evidence, based on the latest national data, on how socioeconomic factors shape CS use in the Philippines.Purpose: This study aimed to analyze the socioeconomic roles in CS delivery in the Philippines.Methods: This study used secondary data from the 2022 Philippines National Demographic and Health Survey (NDHS). The cross-sectional study included 4,452 women aged 15–49 who had given birth within the previous three years. Seven control factors were examined: employment, antenatal care (ANC), age, education, marital status, residence, and parity. The mode of delivery was considered the outcome variable, while socioeconomic status was the exposure variable. Binary logistic regression was used for the final data analysis. Results: CS was performed in 18.45% of deliveries in the Philippines. Analysis of socioeconomic status indicated that women in the poorer group were 1.758 times more likely than those in the poorest group to undergo CS (AOR 1.758; 95% CI 1.757–1.758). Women in the middle group were 2.164 times more likely than the poorest to have a CS (AOR 2.164; 95% CI 2.163–2.165). Those in the richer group were 2.718 times more likely (AOR 2.718; 95% CI 2.717–2.719), and those in the richest group were 4.787 times more likely (AOR 4.787; 95% CI 4.785–4.789) to deliver by CS compared with the poorest.Conclusion: Socioeconomic disparities are strongly associated with CS delivery in the Philippines. The wealthier the mother, the more likely she is to have a CS. ANC education should be optimized by addressing psychological needs, promoting positive values, and providing a sense of security and comfort in normal childbirth. At the same time, equitable access to CS should be ensured for the poorest groups through education and insurance coverage.

Background: Diabetic Peripheral Neuropathy (DPN) is a common complication of type 2 diabetes mellitus (T2DM), and is closely linked to poor glycemic control. However, little is known about how environmental and lifestyle differences between urban and rural settings affect the risk of DPN.Purpose: This study aimed to identify and compare the risk factors of DPN among T2DM patients living in rural and urban areas.Methods: A comparative cross-sectional design with convenience sampling was used to recruit 156 T2DM patients from both urban (Surabaya) and rural (Lamongan) areas of East Java, Indonesia. Data were collected using the Vascular Quality of Life-6 (VQ-6), Diabetic Neuropathy Symptom (DNS), Diabetic Neuropathy Examination (DNE), and Ankle-Brachial Index (ABI). Logistic regression was performed for analysis, with a significance level set at p<0.05.Results: The mean age of rural participants was 55.86 (SD=8.4) years, slightly younger than that of urban participants at 57.27 (SD=9.3) years. Urban residents had higher education levels (37.7%), but engaged less in regular physical activity (51.9%). The risks of DPN were significantly higher in rural areas (p<0.05), with key contributing factors including higher ABI (OR=17.07), more diabetic neuropathic symptoms (OR=3.35), multiple diabetes medications (OR=10.27), lower physical activity (OR=0.24), and lower education level (OR=0.25). Of these, ABI was the strongest predictor of DPN risks.Conclusion: Rural T2DM patients are at greater risk of DPN due to vascular and neuropathic complications combined with sociodemographic disadvantages. These findings highlight the importance of early detection and tailored education programs for rural communities to prevent and manage DPN.

Background: Death is a common occurrence in nursing practice, and nurses are expected to provide professional and sensitive care to families, which can be psychologically demanding. However, there is a paucity of studies describing the experiences of nurses dealing with pediatric end-of-life (EOL) care and death.Purpose: This study explored nurses’ lived experiences following EOL care among pediatric nurses working in two selected hospitals in Nigeria.Methods: A hermeneutic qualitative design was adopted to describe and interpret participants’ experiences. Twenty-one nurses were purposively selected from pediatric wards. Data were collected through semi-structured, in-depth interviews and analyzed using ATLAS.ti with thematic analysis.Results: Five themes emerged: (1) EOL care training during nursing education, (2) experiences of EOL care as a practicing nurse, (3) perceived contributing factors to child death, (4) nurses’ roles in supporting families after child loss, and (5) coping strategies for managing grief after pediatric patient death. The findings revealed that nurses are affected by the death of a child regardless of years of experience. Limited knowledge of EOL care negatively influenced their coping abilities. Nurses considered open grieving unprofessional, with the primary coping strategy being increased commitment to work.Conclusion: The study concluded that years of work experience do not significantly influence nurses’ lived experiences of pediatric patient death. Limited knowledge of EOL care strongly shapes their perspectives on death, dying, and grieving. Grieving is perceived as unprofessional, while dedication to work serves as the preferred coping mechanism. Mandatory training on EOL nursing care and the provision of institutional guidelines are recommended.

Background: Chronic and acute wounds affect millions of individuals worldwide, placing a substantial burden on patients and healthcare systems. Previous evaluations have often focused on limited types of dressings or specific wound conditions. Therefore, a comprehensive network meta-analysis is essential for comparing various interventions, bridging knowledge gaps, improving healing outcomes, and addressing clinical and economic challenges.Purpose: This study assessed the comparative effectiveness and safety of advanced wound dressings in promoting healing.Methods: This network meta-analysis, registered with PROSPERO (CRD42023433268), systematically searched PubMed, ProQuest, Scopus, CINAHL, ScienceDirect, Springer Nature, Wiley, Cochrane Library, and Taylor & Francis from January 2012 to December 2022. Eight reviewers independently assessed and extracted data from randomized controlled trials evaluating different dressings, including placebo, alginate, collagen, gamat, honey, hyaluronic acid, hydrocolloid, hydrogel, mebo, platelet-rich plasma, povidone-iodine, and silver sulfadiazine. Data were synthesized using a random-effects network meta-analysis with SUCRA rankings. Study quality was evaluated using Cochrane RoB2, and certainty of evidence was assessed through CINeMA.Results: This review included 38 RCTs with a total of 4,049 patients. The largest placebo group comprised 1,628 participants, while the smallest group was mebo with 10 participants. Heterogeneity and consistency analysis showed negligible variation (χ²=1.757, p=0.78). Alginate dressings were the most effective in reducing wound size compared to placebo (OR 0.64; 95% CI 0.38–1.08; SUCRA probability 0.73), whereas hyaluronic acid dressings were the least effective (OR 0.22; 95% CI 0.06–0.79; SUCRA probability 0.08).Conclusion: Alginate was identified as the most effective primary dressing for wound healing, while hyaluronic acid dressings were the least effective. However, clinical practitioners should carefully weigh the benefits and limitations of each dressing type before selecting the most appropriate treatment for patients.

Background: The number of older adults with dementia in Indonesia continues to increase. However, many family caregivers still have limited knowledge and skills, which can adversely affect both older adults and caregivers. Existing interventions mainly focus on single aspects of care and have not adequately addressed the physical, psychological, social, and spiritual dimensions. Therefore, there is a need for a comprehensive intervention model that holistically meets caregivers’ needs.Purpose: This study aimed to develop a home-based holistic dementia nursing intervention model for family caregivers and identify its key features.Methods: Three approaches were used for model development: (1) literature review, (2) in-depth interviews, and (3) expert validation. Five articles addressing holistic care dimensions and nursing interventions were included in the review. Fifteen participants took part in the in-depth interviews, and expert validation involved three specialists in the field of geriatrics with specific qualifications. Data were collected between August and September 2022. Analysis was conducted by comparing and synthesizing the findings from the literature review, interviews, and expert validation.Results: The holistic dementia nursing intervention model for family caregivers consisted of four intervention domains: (1) physical, (2) psychological, (3) social, and (4) spiritual. The model also incorporated three key components: (1) communication processes, (2) organizational processes, and (3) belief systems.Conclusion: The home-based holistic dementia nursing intervention model for family caregivers offers a potential conceptual framework to comprehensively address the physical, psychological, social, and spiritual needs of both older adults and their caregivers.