Implementation Of Care Research Articles

Generative AI-driven personalization of the Community of Inquiry model: enhancing individualized learning experiences in digital classrooms

PurposeThis paper explores the integration of generative artificial intelligence (GenAI) into the Community of Inquiry (CoI) framework, focusing on how GenAI can dynamically personalize online learning environments. The study aims to examine how GenAI can enhance social, cognitive and teaching presence, thus meeting the diverse needs of individual learners and improving engagement in digital classrooms.Design/methodology/approachThe paper employs a conceptual approach, building on existing literature about the CoI framework and GenAI. It proposes a theoretical model that illustrates how GenAI can personalize social, cognitive and teaching presence in real-time, using engagement patterns, performance data and feedback mechanisms to adapt learning pathways for individual students.FindingsThe study finds that GenAI can significantly enhance personalized learning by dynamically adjusting the CoI framework’s elements. GenAI-driven interactions improve student engagement through personalized prompts and adaptive content delivery, while AI-generated feedback provides timely and individualized support, fostering a more responsive and student-centered learning experience.Practical implicationsFor educators, the integration of GenAI into the CoI framework offers scalable solutions for personalized instruction and feedback. Institutions can leverage AI-driven insights to create more adaptive, learner-centered environments that improve learning outcomes, satisfaction and engagement, especially in large-scale online courses.Social implicationsThe paper highlights the potential for AI-driven education to bridge gaps in personalized learning, promoting equity and inclusivity. However, it also addresses ethical concerns such as data privacy, algorithmic bias and the digital divide, urging careful implementation to ensure that AI enhances rather than undermines educational fairness.Originality/valueThis paper provides a novel perspective on the intersection of GenAI and the CoI framework, proposing a unique conceptual model for AI-enhanced online education. It offers valuable insights for educators, researchers and institutions aiming to create more personalized, effective and inclusive digital learning environments.

Perspectives and Experiences With Large Language Models in Health Care: Survey Study

BackgroundLarge language models (LLMs) are transforming how data is used, including within the health care sector. However, frameworks including the Unified Theory of Acceptance and Use of Technology highlight the importance of understanding the factors that influence technology use for successful implementation.ObjectiveThis study aimed to (1) investigate users’ uptake, perceptions, and experiences regarding LLMs in health care and (2) contextualize survey responses by demographics and professional profiles.MethodsAn electronic survey was administered to elicit stakeholder perspectives of LLMs (health care providers and support functions), their experiences with LLMs, and their potential impact on functional roles. Survey domains included: demographics (6 questions), user experiences of LLMs (8 questions), motivations for using LLMs (6 questions), and perceived impact on functional roles (4 questions). The survey was launched electronically, targeting health care providers or support staff, health care students, and academics in health-related fields. Respondents were adults (>18 years) aware of LLMs.ResultsResponses were received from 1083 individuals, of which 845 were analyzable. Of the 845 respondents, 221 had yet to use an LLM. Nonusers were more likely to be health care workers (P<.001), older (P<.001), and female (P<.01). Users primarily adopted LLMs for speed, convenience, and productivity. While 75% (470/624) agreed that the user experience was positive, 46% (294/624) found the generated content unhelpful. Regression analysis showed that the experience with LLMs is more likely to be positive if the user is male (odds ratio [OR] 1.62, CI 1.06-2.48), and increasing age was associated with a reduced likelihood of reporting LLM output as useful (OR 0.98, CI 0.96-0.99). Nonusers compared to LLM users were less likely to report LLMs meeting unmet needs (45%, 99/221 vs 65%, 407/624; OR 0.48, CI 0.35-0.65), and males were more likely to report that LLMs do address unmet needs (OR 1.64, CI 1.18-2.28). Furthermore, nonusers compared to LLM users were less likely to agree that LLMs will improve functional roles (63%, 140/221 vs 75%, 469/624; OR 0.60, CI 0.43-0.85). Free-text opinions highlighted concerns regarding autonomy, outperformance, and reduced demand for care. Respondents also predicted changes to human interactions, including fewer but higher quality interactions and a change in consumer needs as LLMs become more common, which would require provider adaptation.ConclusionsDespite the reported benefits of LLMs, nonusers—primarily health care workers, older individuals, and females—appeared more hesitant to adopt these tools. These findings underscore the need for targeted education and support to address adoption barriers and ensure the successful integration of LLMs in health care. Anticipated role changes, evolving human interactions, and the risk of the digital divide further emphasize the need for careful implementation and ongoing evaluation of LLMs in health care to ensure equity and sustainability.

Evaluating the Impact of Tele-critical Care Implementation on Inpatient Mortality and Length of Stay

Evaluating the Impact of Tele-critical Care Implementation on Inpatient Mortality and Length of Stay

GPU Optimization for Causal AI: Accelerating the PC Algorithm

GPU acceleration is revolutionizing causal inference through the PC algorithm, transforming a previously computationally prohibitive task into a practical analytical approach for complex, high-dimensional datasets. The architecture of modern GPUs, with their massively parallel processing capabilities, aligns perfectly with the inherent parallelism of conditional independence tests central to causal discovery. From algorithm redesign to memory optimization and precision considerations, careful implementation strategies can yield performance improvements of several orders of magnitude compared to traditional CPU implementations. The evolution from NVIDIA A10 to A100 and H100 GPUs has progressively reduced computation times and expanded practical dataset sizes, enabling real-time causal inference applications in fields ranging from finance and healthcare to industrial control systems. This technological advancement bridges the gap between theoretical causal modeling and practical deployment, moving AI systems beyond correlation to understand true causal relationships.

Manajemen Pemberian Diet DASH (Dietary Approach to Stop Hypertension) dengan Penambahan Buah Kurma (Phoenix dactylifera L.) pada Penderita Hipertensi Kronis dalam Kondisi Puasa: Case Report

The Diet Dietary Approach to Stop Hypertension (DASH) diet limits sodium and saturated fat and is high in fiber and minerals that can help control blood pressure. Date fruits are high in fiber and contain minerals and polyphenolic compounds that can lower blood pressure along with the DASH diet. This report is to observe the effect of DASH diet with date fruit combination on blood pressure changes in chronic hypertensive clients under fasting conditions. The study design was a single case study design to observe the effect of DASH diet combined with date fruit on hypertensive patients in fasting conditions. Subjects are patients undergoing homecare nutrition or diet programs by a nutritionist. The intervention was carried out for five days. The procedures include nutritional screening and assessment, diagnosis and nutritional care planning, implementation of nutritional care, and monitoring and evaluation. Data were analyzed through a descriptive approach to describe changes in blood pressure. Respondents' food intake during the intervention reached &gt;80% of needs. Sodium intake was &lt;1500 mg/day and fiber was&gt;20 g/day. Blood pressure before the intervention showed grade I hypertension, while blood pressure on day 1 to day 5 of the intervention showed normal. The DASH diet combined with the provision of dates can support the reduction of blood pressure in patients with hypertension. Keywords: DASH Diet, date fruit, hypertension, fasting

Bridging the Research Gap: The Potential and Limitations of Self-Help Interventions for Eating Disorders on Mental Health. Commentary on Linardon etal. (2025).

Many individuals with eating disorders lack access to evidence-based treatment due to stigma, therapist shortages, and logistical barriers. Digital self-help interventions offer a scalable alternative, delivering structured therapy without direct therapist involvement. While they effectively reduce eating disorder symptoms, their broader mental health benefits remain unclear. Linardon etal. conducted a meta-analysis of 27 randomized controlled trials, reporting modest but meaningful improvements in depression, anxiety, distress, and self-esteem in at-risk or symptomatic samples. However, evidence remains inconclusive for clinical samples. These findings support self-help as a low-cost treatment option, yet key research gaps persist. The mechanisms driving mental health improvements are poorly understood, reliance on waitlist control groups may inflate effect sizes, and study samples lack diversity. Additionally, further research is needed on the use of digital self-help for adolescents and individuals in remote or underserved areas, as well as their effectiveness. Future research should incorporate better control conditions, standardize outcome measures, and explore strategies for implementation in routine care. Addressing these gaps will strengthen the evidence base and enhance the accessibility of self-help interventions for eating disorders.

Assessing the Landscape of Quality Care Nursing Metrics in General Practice Settings: A Scoping Review.

To synthesise current evidence on the development and implementation of quality care metrics for nurses working in general practice. A Scoping review guided by Arksey and O'Malley's framework and the Preferred Reporting Items for Systematic Reviews and Meta-Analysis for Scoping Reviews (PRISMA-ScR). Articles included peer-reviewed primary research, published in English between 1989 and 2024, reporting on the development, implementation and evaluation of quality care nursing metrics in general practice settings. EndNote was used for citation management, while Covidence facilitated screening and data extraction by four reviewers. The Donabedian model of quality care assessment (2005) and the WHO tool for primary care nurse competencies (2020) were used to synthesise the findings. A systematic search of PubMed, CINAHL, EMBASE and Web of Science databases was conducted between June 2022 and June 2024. The search strategy was developed using Population, Concept and Context criteria, with keywords including 'Nurse', 'General Practice', 'Metric' and 'Indicator.' Eleven studies conducted between 2005 and 2024 met the inclusion criteria. Five studies focused on quality care indicators or measures, and six examined nurse competencies or standards of care. Quality care metrics are underutilised in general practice. There is ambiguity in metric terminology and nursing roles, education and primary care systems. Quality care metrics must align with nursing values, with digital technology and leadership as core enablers. Adoption of nursing metrics in general practice provides insights into nursing contributions to patient care. Standardising the definitions of nursing care metrics will enable valid and reliable comparisons. Quality care nursing metrics will enable the nurse's role to be manifested in general practice settings in relation to patient outcomes. PRISMA reporting guidelines have been adhered to. WHAT DOES THIS PAPER CONTRIBUTE TO THE WIDER GLOBAL CLINICAL COMMUNITY?: Understanding of the role of the nurse in general practice will support improved quality, safety, policy and governance in general practice settings. No patient or public contribution.

Characterizing Intervention Components and Complexity of Nonpharmacologic Healthcare Interventions to Manage Distress Behaviors in Older Adults.

Distress behaviors are common in residential care settings and contribute to staff burnout and poor quality of life for older adults. While nonpharmacologic interventions reduce distress behaviors, implementation in routine care remains challenging. Our study applies a narrative reanalysis of interventions identified in a systematic review to describe the setting, focus, core components, and complexity of interventions identified. Most interventions occurred in post-acute settings, followed by transitions between care settings and inpatient mental health settings. Identified interventions were highly complex and heterogeneous regarding the components assessed and the details reported. Intervention components focused on patients, healthcare workers, environmental, and multiple levels. Common patient-level components included individualized care plans, distress behavior detection, medical management, and symptom monitoring. Common staff-level components included education and healthcare team workflow. Current evidence does not provide sufficient detail to replicate these interventions. We provide a template for standardized intervention testing and reporting implementation.

Effect of Home-Based Palliative Care on Quality of Life in Patients With Cancer: A Systematic Review and Meta-analysis of Randomized Controlled Trials.

The implementation of home-based palliative care for patients with cancer aims to relieve suffering and improve quality of life, regardless of disease stage. However, outcomes of such interventions have been inconclusive. This study investigated the effect of home-based palliative care on the quality of life in patients with cancer. Six databases (CINAHL, Cochrane Library, EMBASE, MEDLINE, PubMed, Web of Science) were searched for relevant studies up to June 9, 2024. Randomized trials involving patients with cancer receiving home-based palliative care were included. A forest plot was generated using the DerSimonian and Laird random-effects model. A total of 8 studies were included in the final analysis. Home-based palliative care appeared to enhance the quality of life of patients with cancer (pooled standard mean difference, 0.45 [95% confidence interval, 0.04-0.86]; P = .03). Home-based palliative care improves the quality of life for patients with cancer. Further research with larger sample sizes and more rigorous methodologies is needed. The findings highlight the value of home-based palliative care as a model to address the needs of patients with cancer at home, improving their quality of life, similar to hospital-based care.

Design of Appropriate Educational Methods for Nurses in Implementing Urinary Tract Infection (UTI) Bundles

During catheterization procedures, nurses have a crucial role in determining the transmission of infectious agents. This is because they work closely with patients and manage urinary tract infection (UTI) bundles. Therefore, it's essential to reconsider nursing education approaches so that nurses get more conscious by working together to identify challenges and develop self-motivation abilities. Twenty associated nurses in patient rooms are involved in a qualitative action research project. To inspire nurses to manage UTI bundles, the research aims to work with participants to determine the most effective learning methodologies to raise their comprehension and awareness of their role as nursing care implementers. This study employed focus group discussions (FGD) to explore experiences and test emotions. Frederick Herzberg's motivation theory is used to identify nurse motivation. Based on the findings of FGD with participants and experts, education to motivate implementing nurses was found to be the most appropriate educational technique design after conducting qualitative data analysis. This program aims to provide psychological support to participants. Participants were observed and questioned one month later during the Reflecting stage. Experts in psychology conducted questionnaires before and after motivational education sessions, and the results indicated a noteworthy rise in motivation—from 35% to 80%. In addition to the insights gained from interviews conducted during FGD, it was determined that participants felt more intrinsically motivated and were more conscious of the need to perform nursing acts professionally.

AI-generated questions for urological competency assessment: a prospective educational study

BackgroundThe integration of artificial intelligence (AI) in medical education assessment remains largely unexplored, particularly in specialty-specific evaluations during clinical rotations. Traditional question development methods are time-intensive and often struggle to keep pace with evolving medical knowledge. This study evaluated the effectiveness of AI-generated questions in assessing urological competency among medical interns during a standardized clinical rotation.MethodsTwo state-of-the-art AI language models (ChatGPT and Gemini) generated 300 multiple-choice questions across six urological subspecialties. Seven experienced urologists, each with over 10 years of clinical practice and active involvement in resident training programs, independently evaluated the questions using a modified Delphi approach with standardized scoring rubrics. The evaluation criteria encompassed technical accuracy based on current clinical guidelines, clinical relevance to core rotation objectives, construct validity assessed through cognitive task analysis, and alignment with rotation objectives. Questions achieving consensus approval from at least five experts were retained, resulting in 100 validated questions.ResultsFrom the initial cohort of 45 eligible interns, 42 completed all three assessment points (93.3% completion rate). Performance improved significantly from baseline (mean: 45.2%, 95% CI: 42.6–47.8%) through mid-rotation (mean: 62.8%, 95% CI: 60.4–65.2%) to final assessment (mean: 78.4%, 95% CI: 76.5–80.3%). The technical accuracy was comparable between AI platforms (ChatGPT: 84.3%, Gemini: 83.8%, p = 0.86). Clinical scenario questions demonstrated better discrimination than recall questions (mean indices: 0.28 vs. 0.14, p < 0.001). Subspecialty performance varied, with highest scores in uro-oncology (mean: 82.6%, 95% CI: 80.2–85.0%) and endourology (mean: 79.4%, 95% CI: 77.0-81.8%).ConclusionsAI-generated questions showed appropriate technical accuracy and difficulty levels for assessing clinical competency in urology. While promising for formative assessment, particularly with clinical scenarios, current limitations in discrimination capability suggest careful consideration for high-stakes testing. The strong correlation between clinical exposure and improved performance validates their effectiveness in measuring knowledge acquisition. These findings support the potential integration of AI-generated questions in specialty-specific assessment, though careful implementation with expert oversight and continuous validation remains essential.Clinical trial numberNot applicable.

New ways of working as a physiotherapist in the digital era: A qualitative study

Background The digital transformation of health care is moving fast and development of ways of working take place in clinical practice. Objective The aim of this qualitative study was to explore how physiotherapists in primary health care describe their approaches to working in video-based digital physiotherapy. Methods The study was based on semi-structured in-depth interviews with ten physiotherapists with varying levels of experience in primary health care. The interviews were analysed using qualitative content analysis. Results The results show that adapting physiotherapy to a new digital arena is a demanding process. Five categories were identified: Reorientation of clinical reasoning for a digital setting, a substantial transformation of the healthcare system, the impact of professional identity on adaptability, managing unknown expectations, and working in a new arena brings new demands and opportunities. The physiotherapists described a shift that required the development of conversational skills, new methods for gathering assessment data, and the adaptation of interventions to fit digital environments. The study also highlights the need for targeted education, support, and research to guide the development and implementation of digital care. Conclusions The evolution of the professional role in digital physiotherapy should be recognised as a challenging process. To support individual physiotherapists, there is a need for a strong structural foundation in terms of education and technology.

Cross-Faith Spiritual Nursing Service Training on Nurses’ Knowledge, Skills, and Attitudes in The Hospital

The implementation of spiritual nursing care in hospitals has not yet been optimal. Nurses, as professional healthcare providers, must be able to understand spirituality and how spiritual beliefs affect everyone’s life. Spiritual needs are the need for meaning, purpose, and hope in life, relationships with God, religious obligations, spiritual practices, relationships with others, and relationships with nurses. This study aimed to determine the effect of interfaith spiritual care training on nurses' knowledge, attitudes, and skills in providing spiritual nursing care. The research design is quantitative, using a pre-experimental pre-posttest group design. Purposive sampling was used to select samples that met the inclusion and exclusion criteria. The Wilcoxon test results showed a value of 0.001 (p-value &lt; 0.05), indicating a significant difference in knowledge, attitudes, and skills before and after the spiritual nursing care training. This study concludes that interfaith spiritual care training positively influences nurses' knowledge, attitudes, and skills. It contributes to the field by introducing and validating a novel, interfaith-focused training program that significantly enhances nurses’ professional competencies in providing spiritual care.

Comprehensive Overview of the Impact of Hybrid CPD Models on EFL Teacher Efficacy and Student Outcomes in the National Context

Continuing professional development is essential for enhancing the quality of teaching and learning in English as a Foreign Language education. Hybrid CPD models have been a central focus in language teaching for decades, with various models and approaches proposed to enhance teacher competencies and student learning outcomes. However, the literature lacks a comprehensive review of the existing models, applications, and impacts of hybrid CPD on EFL/ESL teachers. This paper addresses this gap by providing a theoretical review of hybrid CPD models, their key characteristics, and empirical evidence on their effectiveness in improving teacher efficacy and student achievement in national contexts. This research paper presents a comprehensive analysis of the impact of hybrid CPD models, which combine face-to-face and online components, on English as a Foreign Language teacher efficacy and student outcomes in a national context. This study explores the key characteristics, goals, and applications of these hybrid CPD models, their empirical impact on teachers’ pedagogical knowledge, self-efficacy, and professional identity, and the subsequent influence on student engagement, achievement, and language proficiency. The findings of this study indicate that hybrid CPD models can significantly enhance EFL teacher competencies and improve student learning outcomes when designed and implemented effectively, considering contextual factors. Specifically, the impact of hybrid CPD models on EFL teacher efficacy and student outcomes was multifaceted. These models can foster the development of teachers’ pedagogical knowledge, self-efficacy, and professional identity, which, in turn, can lead to improved student engagement, achievement, and language proficiency. However, the effectiveness of hybrid CPD models is contingent on careful design and implementation that considers the unique contextual factors of the educational setting, such as infrastructure, access to technology, and cultural norms. When implemented thoughtfully and with attention to context, hybrid CPD models can be powerful tools for enhancing the quality of English teaching and learning quality.

Continuity of Care Implementation for Mrs. R at Al Islam H.M. Mawardi Hospital

Continuity of Care Implementation for Mrs. R at Al Islam H.M. Mawardi Hospital

Improving fine needle aspiration in value-based thyroid cancer care: an interrupted time series analysis

BackgroundValue-Based Health Care (VBHC) implementation motivates providers to reduce unnecessary procedures to improve outcomes and costs, i.e. value. In thyroid cancer care, adequate use of Fine Needle Aspiration (FNA) may prevent downstream diagnostics, costs, and delays in the care process. This study aims to evaluate the impact of needle selection in FNA on Bethesda I classifications, duration of FNA appointments, and care utilization.MethodsIn October 2021, a Modified Menghini-type needle needle replaced the regular syringe needle used for FNA. An interrupted time series (ITS) analysis using generalized linear models was conducted with data from radiology and pathology reports coupled with care utilization data at the patient level. Outcomes included frequency of Bethesda I classifications per month, appointment time, and health care utilization in the first patient year (in 2024€).ResultsBetween July 2020 and May 2022, 345 FNA in 224 patients were included. Implementation of the Modified Menghini-type needle needle was associated with a 78% level decrease in the odds of Bethesda I classification during FNA (OR (95% CI) 0.22 (0.06;0.71)), and, on average, a 4% (1.25 min) reduction in FNA appointment time. Despite a higher FNA unit cost postintervention (additional cost of €17.56 per FNA), there were no changes in the diagnostic and overall costs.ConclusionVBHC implementation provides the tools to identify and monitor improvement projects that enhance the value of thyroid nodule diagnostics and management. Implementing a Modified Menghini-type needle needle in FNA resulted in increased adequate diagnostic results, time savings, and no changes in diagnostic and care costs.Clinical trial numberNot applicable.

Palliative Care and Advanced Cardiovascular Disease in Adults: Not Just End-of-Life Care: A Scientific Statement From the American Heart Association.

Cardiovascular disease remains a leading cause of morbidity and mortality in adults despite recent scientific advancements. Although people are living longer lives, there may be an adverse impact on quality of life, necessitating a greater need for palliative care services and support. Palliative care for adults with advanced cardiovascular disease has the potential to significantly improve quality of life for individuals living with cardiovascular disease and their informal care partners. Effective communication, shared decision-making, age-friendly care principles, and advance care planning are vital components of palliative care and support comprehensive and holistic care throughout the advanced cardiovascular disease trajectory and across care settings. Current evidence highlights the benefits of palliative care in managing symptoms, reducing psychological distress, and supporting both people with cardiovascular disease and their care partners. However, significant gaps exist in palliative care research related to non-heart failure populations, care partner outcomes, and palliative care implementation in diverse populations. This scientific statement (1) discusses the application of effective communication, shared decision-making, age-friendly care, and advance care planning in advanced cardiovascular disease palliative care; (2) provides a summary of recent evidence related to palliative care and symptom management, quality of life, spiritual and psychological support, and bereavement support in individuals with advanced cardiovascular disease and their care partners; (3) discusses issues involving diversity, equity, and inclusion in cardiovascular disease palliative care; (4) highlights the ethical and legal concerns surrounding palliative care and implanted cardiac devices; and (5) provides strategies for palliative care engagement in adults with advanced cardiovascular disease for the care team.

Palliative and supportive care in patients with hepatocellular carcinoma: a qualitative study on attitudes and perceptions of health professionals

BackgroundIntegration of palliative and supportive care in cancer treatment pathways is becoming standardised. While there has been significant qualitative research in oncology on palliative and supportive care integration into clinical care, there is little evidence that focusses on clinicians who manage hepatocellular carcinoma (HCC) and their perceptions on palliative and supportive care.AimTo investigate the attitudes and perceptions regarding palliative and supportive care of healthcare professionals managing patients with HCC.DesignQualitative study involving semi-structured individual interviews transcribed verbatim and analysed thematically.Setting/participants.A total of 25 healthcare professionals including hepatologists, gastroenterology trainees, hepatology clinical nurse consultants, social workers, and palliative care specialists providing care to patients with HCC recruited at 4 tertiary hospitals via purposive sampling.ResultsThe following themes emerged: (1) availability of palliative care services, (2) need for clear referral pathways and processes, (3) patients’ limited understanding of palliative care, (4) recognition of benefits of palliative care, and (5) the lack of training in hepatology services for palliative care provision.ConclusionHealth professionals’ perceptions of integration of palliative and supportive care in liver cancer care are hampered by multiple barriers. Opportunities to establish a more cohesive approach to care integration for patients with liver cancer have been identified. Trial RegistrationACTRN12623000010695 (date of registration 9/01/2023). What is already known about the topic?• Integration of palliative and supportive care for cancer can have profound benefits for patients’ symptom burden and quality of life.• There is a lack of empirical studies examining the perspectives of health professionals who manage liver cancer on the integration of palliative and supportive care into the treatment pathways for patients.What this paper adds• This study identifies a number of barriers to the implementation of palliative and supportive care into liver cancer treatment algorithms.• The absence of sufficient evidence in clinical guidelines impairs the capacity of health professionals to improve the integration of palliative and supportive care for liver cancer patients.Implications for practice, theory, or policy.• As liver cancer prevalence increases, further effort is required to develop appropriate evidence-based clinical guidelines and referral pathways to support the integration of palliative and supportive care within existing liver cancer services.

Psychiatric nurses' experiences of using a model to improve relationships of couples with borderline personality disorder.

Individuals with borderline personality disorder (BPD) struggle with relationships because of impulsivity and emotional regulation difficulties. Specialised skills are needed for care, but existing models are lacking. A new model was developed to help psychiatric nurses support couples with one partner having BPD. This innovative psychiatric nursing model emphasises the need for implementation and evaluation in care. To explore the psychiatric nurses' experiences of implementation of a model to facilitate constructive intra- and interpersonal relationships for couples in a relationship where one is living with BPD. The study was conducted at a mental health institution in Gauteng province where the one partner with BPD receives treatment. The study adopted a qualitative, exploratory design conducting in-depth interviews with psychiatric nurses who implemented the model, triangulated with observations and field notes and analysed thematically. Four themes emerged, namely: (1) the model served as a helpful tool for empowerment; (2) the positive results yielded by the model; (3) challenges related to using the model; and (4) suggestions for expanding the model's reach. The psychiatric nurses found the model acceptable and feasible to facilitate the relationships of couples where one is living with BPD. Psychiatric nurses need guidelines to enhance care for individuals with BPD, highlighting the importance of implementing supportive models to improve relationships in various settings. Implementation of this model is unique in the care of persons living with BPD making it a valuable tool for psychiatric nurses in mental health care provision.

Effect of nursing application of emotion freedom technique on perceived stress, resilience and sexual satisfaction among women after mastectomy

BackgroundA breast cancer diagnosis extends beyond physical health concerns, profoundly impacting a woman’s psychological well-being, resilience and sexual satisfaction. Mastectomy intensifies these challenges, potentially affecting overall quality of life and long-term well-being. Understanding the interrelationships between perceived stress, resilience and sexual satisfaction is crucial for designing targeted interventions that effectively support mastectomized women. This study evaluates the effectiveness of the Emotional Freedom Technique in mitigating stress, enhancing resilience and improving sexual well-being post-mastectomy.MethodsA quasi-experimental pretest-posttest design was employed with a convenient sample of 112 Egyptian women who had undergone mastectomy. Participants were recruited from the Outpatient Oncology Clinic at Beni-Suef University Hospital. Data were collected over six months (January–June 2024) and analyzed using SPSS version 26.0. The intervention consisted of six structured EFT sessions delivered over six weeks. Paired t-tests assessed pre- and post-intervention differences, while Pearson and Spearman correlation analyses examined relationships between variables to accommodate different data distributions.ResultsPost-intervention assessments revealed statistically significant improvements. Perceived stress scores decreased from 32.42 ± 1.70 to 17.27 ± 2.96 (t = 49.130, p < 0.001, Cohen’s d = 3.2), resilience scores increased from 11.53 ± 1.67 to 31.46 ± 5.48 (t = 36.454, p < 0.001, Cohen’s d = 2.8) and sexual satisfaction scores improved from 17.03 ± 1.55 to 31.00 ± 4.31 (t = 13.245, p < 0.001, Cohen’s d = 2.5). Strong negative correlations were found between perceived stress and both resilience (r = -0.692, p < 0.001) and sexual satisfaction (r = -0.835, p < 0.001), while resilience and sexual satisfaction were strongly positively correlated (r = 0.890, p < 0.001).ConclusionEFT is a cost-effective, non-invasive intervention that significantly reduces stress, enhances resilience and improves sexual satisfaction in women post-mastectomy. To optimize clinical integration, healthcare institutions should develop structured EFT training programs for nurses, incorporating theoretical foundations, hands-on practice and competency assessments. Standardized protocols should be established to guide EFT implementation in post-mastectomy care. Further research should explore long-term effects and broader applicability across diverse healthcare settings.Clinical trial numberNCT06583629 on 4/9/2024.