Interdisciplinary Journal of Nursing and Health
Interdisciplinary Journal of Nursing and Health is an international, peer-reviewed, open-access journal dedicated to advancing nursing science, healthcare research, and evidence-based clinical practice. The Journal publishes original research, methodological contributions, and interdisciplinary studies addressing patient care, professional practice, healthcare systems, and health policy. Through an international editorial network, the Journal promotes scientific excellence, critical discussion, and collaboration across nursing and health disciplines.
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Self-Care and Caregiver Contribution to Self-Care in Dyads Receiving Oral Anticancer Treatment (Dyads-in-Cancer): A Protocol for an Observational Longitudinal Study
Introduction. The use of oral anticancer agents (OAAs) has increased in recent years. These medications have many benefits, including improved tolerability, adaptability, and decreased stress compared to intravenous treatments. However, studies have shown that there are potential challenges with these treatments, including poor adherence and limited multidisciplinary support. As a result, it is important to focus on self-care behaviours for managing OAA treatment from a dyadic perspective. However, self-care levels in this population and the contribution of informal caregivers to self-care have yet to be extensively described, along with their predictors and outcomes. Therefore, the aim of this study is to describe a research protocol of a multicentre observational longitudinal study designed to investigate the self-care of patients with cancer taking OAAs and the caregivers’ contribution to this self-care, and to examine the self-care predictors and outcomes. Methods. This study will recruit patients with cancer undergoing OAA treatment and their informal caregivers. Data collection will include patient and caregiver sociodemographic factors, patient clinical information, patient self-care and caregiver contribution to self-care, variables at patient-, caregiver- and dyad-level that can predict self-care and caregiver contribution to self-care. We will also investigate whether self-care and caregiver contribution to self-care can predict important patient outcomes (e.g. emergency room access, rehospitalization, survival, quality of life) and/or caregiver outcomes (e.g. the positive aspects of caregiving). Data analyses will include descriptive statistics, regressions, ANOVAs, structural equation modelling, and dyadic analyses. Discussion. This research will enhance the understanding of self-care in patients with cancer taking OAA and caregivers’ contribution to self-care. It will provide insights on the factors that influence self-care and important outcomes. The findings of this study will inform future research and guide tailored interventions to improve patient self-care and caregiver support.
Copyright (c) 2026 Marco Di Nitto, Silvia Ucciero, Francesco Torino, Federica Lacarbonara, Valentina Biagioli, Izabella Uchmanowicz, Angela Durante, Ercole Vellone https://creativecommons.org/licenses/by/4.0
Self-Care Research: Expanding New Frontiers for Nursing Science
Copyright (c) 2026 Ercole Vellone, Davide Ausili, Maddalena De Maria, Maria Matarese https://creativecommons.org/licenses/by/4.0
Association between Problem-Solving Skills and Knowledge of the Nursing Process and Standardized Nursing Languages among Undergraduate Nursing Students
Introduction. Problem-solving skills and the use of Standardized Nursing Languages (SNLs) are essential for clinical reasoning in nursing education, yet their relationship has been insufficiently explored. This study aimed to describe nursing students’ characteristics alongside their problem-solving skills, compare these across program years, and identify predictors of their knowledge of the nursing process and SNLs, with a specific focus on problem solving. Methods. A prospective observational study was conducted in 2024–2025 among undergraduate nursing students in a public university in Italy. Data were collected through an online survey including a knowledge test on SNLs, the Positions on Nursing Diagnosis scale, and the Problem-Solving Inventory (PSI). Descriptive statistics, ANOVA, correlation analyses, and multiple linear regression were performed. Results. A total of 352 students participated (87.5% female; mean age 22.79). Knowledge levels did not significantly differ across academic years. Higher knowledge was associated with better academic performance, stronger intention to use nursing diagnoses, and higher PSI-Self-Assurance, while larger class size and male sex were negatively associated with knowledge. Regression analysis identified PSI-Self-Assurance, intention to use nursing diagnoses, class size, and sex as significant predictors (R² = 0.11). Discussion. Knowledge of the nursing process and SNLs appears to be more strongly influenced by motivational and cognitive factors than by academic progression alone. Confidence in problem-solving and intentional engagement with nursing diagnoses emerge as key elements in supporting diagnostic reasoning.
Copyright (c) 2026 Roberta Morandini, Alessandro Bonacci, Andrea Gazzelloni, Rosaria Alvaro, Gianluca Pucciarelli, Fabio D'Agostino, Valentina Zeffiro https://creativecommons.org/licenses/by/4.0
Understanding Clinical Teaching in Midwifery Education: Validation of the MidPaACT Tool in the Italian Context
Introduction. Midwifery education integrates theoretical instruction with clinical practice, in which supervisory relationships are pivotal. The quality of mentorship substantially influences students’ competence, confidence, and professional identity, and is largely determined by midwives’ awareness of their role as preceptors and how this is enacted in practice. This study aims to provide a valid instrument for evaluating clinical teaching in midwifery education by translating, culturally adapting, and psychometrically validating the Midwifery Perceptions and Assessment of Clinical Teaching (MidPaACT) tool in the Italian context. Methods. The MidPaACT questionnaire was translated and culturally adapted following established international guidelines. The process included forward translation, synthesis, back translation, expert panel review, and pilot testing. Data were collected through an online survey completed by preceptor midwives involved in undergraduate midwifery education. Construct validity was assessed using confirmatory factor analysis using a Diagonally Weighted Least Squares estimator. Model fit was evaluated using RMSEA, SRMR, CFI, and TLI indices. Internal consistency reliability was assessed using Cronbach’s alpha coefficients. Results. A total of 168 preceptor midwives participated. Confirmatory factor analysis supported the original two-factor structure (‘Supporting students to learn’ and ‘Safety in learning’) and indicated acceptable model fit (RMSEA = 0.08; SRMR = 0.105; CFI = 0.973; TLI = 0.971). Internal consistency was satisfactory for both subscales (α = 0.88 and α = 0.77). Participants reported high levels of engagement in supporting student learning and ensuring safety in clinical practice, while highlighting areas for improvement in academic–clinical collaboration and culturally responsive supervision. Discussion. The Italian version of the MidPaACT demonstrates satisfactory psychometric properties and provides a valid tool for the systematic evaluation of clinical teaching in midwifery education. Its use can support the development of targeted faculty development initiatives and strengthen evidence-informed approaches to improving the quality of clinical education.
Copyright (c) 2026 Serena Neri, Maria Panzeri, Margaret Smith, Simona Fumagalli, Sofia Colaceci https://creativecommons.org/licenses/by/4.0
The PREVASC Model in Cardiovascular Prevention for the Frail Older Adult: A Person-Centred, Dignity-Driven Multidisciplinary Approach to Value-Based Care
Introduction. Cardiovascular diseases are the leading cause of morbidity and mortality in older adults, highlighting the need for effective preventive strategies. Structured screening programs may enhance the early detection and management of cardiovascular risk factors in this population. To describe the impact of the PREVASC multidisciplinary model in promoting collaboration in cardiovascular prevention, collecting evidence on cardiovascular risk, and assessing gender differences in cardiovascular risk prevention among the older population. Methods. In this descriptive correlational cross-sectional study data were collected from 1,836 participants aged 65–94 years enrolled in the PREVASC screening program. All professionals involved in the PREVASC screening campaign entered data into a standardized data collection system. Participants underwent structured cardiovascular assessments, and adherence to pharmacological therapy, sociodemographic characteristics, and time spent at the screening center were recorded. Descriptive statistics were used to analyze frequencies, percentages, and measures of central tendency and dispersion. Results. Among the scheduled participants, 1,640 (89.37%) attended the screening, while 196 (10.63%) did not. Adherence to pharmacological therapy was high, with 1,453 participants (90%) reporting ongoing treatment; adherence was higher among women (91.4%) than men (88.3%). The mean age of participants was 72.52 years, with a predominance of women (55.9%). The average time spent at the screening center was 1 hour and 3 minutes (range: 22 minutes–3 hours and 47 minutes), indicating an efficient organizational structure. Discussion. The PREVASC program demonstrated high participation rates and sustainable operational performance, supporting the feasibility of structured cardiovascular screening in older adults. The integration of multiprofessional expertise and community-based preventive activities represents a replicable model for effective cardiovascular prevention and early risk identification, with potential relevance for public health planning.
Copyright (c) 2026 Francesco Zaghini, Chiara Vergari, Rocco Mazzotta, Roberta Morandini, Alessandro Boccanelli, Donatella Padua, Vera Kopsaj, Gianluca Cortis, Niccolò Marchionni, Nazario Carrabba, Matteo Amico, Eleonora Selvi, Ercole Vellone, Francesco Scerbo, Rosario Alvaro https://creativecommons.org/licenses/by/4.0
Improving Symptom Perception in Recently Discharged Patients with Heart Failure: Protocol for a Single-Centre Randomised Controlled Trial of a Nurse-Led Teach-Back Intervention
Introduction. Heart failure (HF) is a chronic condition associated with substantial symptom burden, frequent hospitalisations, and increased morbidity and mortality. Nurse-led informational–educational interventions, particularly those based on the teach-back method, may support patients in monitoring and interpreting HF-related symptoms, improving self-care behaviours and medication adherence, and potentially contributing to long-term clinical stability after discharge. Objective. To evaluate the effectiveness of a face-to-face nurse-led informational–educational intervention using the teach-back method on patient-reported perception and severity of HF-related somatic symptoms at 3 months after the first outpatient cardiology follow-up visit in patients recently discharged with HF. Trial design. Single-centre, open-label, parallel-group randomised controlled trial with 1:1 allocation (intervention vs control). Participants and Settings. Patients recently discharged from a cardiology unit with a diagnosis of HF will be enrolled and randomised at their first outpatient cardiology follow-up visit. Assessments will be conducted at baseline and at 3, 6, 9, and 12 months. Interventions. The intervention consists of a 30-minute nurse-led face-to-face informational–educational session structured according to the teach-back method, focused on HF symptom monitoring, interpretation of worsening symptoms, and self-care behaviours. The session will be reinforced through a follow-up phone call. The control group will receive usual care. Primary/Secondary Outcomes. The primary outcome is patient-reported symptom perception and severity of HF-related somatic symptoms at 3 months, measured using the Heart Failure Somatic Perception Scale (HFSPS). Secondary outcomes include self-care behaviours assessed with the Self-Care of Heart Failure Index (SCHFI v8.0), medication adherence measured using the General Medication Adherence Scale (GMAS), and clinical stability during follow-up. Disease-specific quality of life will be assessed exploratorily using the Kansas City Cardiomyopathy Questionnaire (KCCQ). Ethical Considerations. Ethical approval has been obtained from the Comitato Etico Lombardia 1 (approval number CET 195-2025). The trial has been registered on ClinicalTrials.gov (identifier: NCT07280728).
Copyright (c) 2026 Greta Ghizzardi, Martina Torreggiani, Ercole Vellone, Stefania Lorenzani, Fanny Zafferri, Luciana Ghizzinardi, Eleonora Aloi, Stefano Maiandi, Domenico Scognamiglio, Luca Poggio, Pietro Mazzarotto https://creativecommons.org/licenses/by/4.0
Vocation in Healthcare Professions: Between Philosophical Legacy and Contemporary Challenges
The concept of vocation, traditionally associated with religious and spiritual dimensions, has taken on a new meaning in contemporary society, particularly within the context of healthcare professions. This article explores the transformation of vocation from a “divine calling” to a conscious professional choice, focusing on the reflections of philosophers such as Husserl, Blum, Kierkegaard, Weber, and Ricoeur. In light of the global health crisis and increasing organizational disenchantment, it proposes a reinterpretation of vocation as a tool to restore meaning, ethics, and humanity to caregiving professions.
Copyright (c) 2026 Silvia Sturniolo https://creativecommons.org/licenses/by/4.0
Psychometric Properties and Measurement Invariance of the Parental Health Locus of Control Scale in an Italian Population
Introduction. Parents play a pivotal role in shaping children’s health behaviors, preventive practices, and adherence to medical recommendations. The Parental Health Locus of Control (PHLOC) scale measures parental beliefs about the sources of control over child health outcomes. Although an Italian version exists, its psychometric properties had not yet been comprehensively evaluated. This study aimed to validate the Italian version of the PHLOC by assessing its factorial structure, internal consistency reliability, convergent validity with health literacy and vaccine hesitancy measures, and measurement invariance across healthcare professionals and non-healthcare professionals. Methods. A cross-sectional psychometric study was conducted among 308 Italian parents of children aged 0–18 years using EUSurvey®. Confirmatory factor analysis (CFA) tested the six-factor structure of the PHLOC (Parent, Child, Professionals, Media, Divine, Fate), and internal consistency was assessed with McDonald’s omega. Convergent validity was examined through correlations with health literacy (HLS-EU-Q6) and vaccine hesitancy (PACV-5). Measurement invariance by professional status was evaluated using a Multiple Indicators Multiple Causes (MIMIC) model. Results. CFA supported the six-factor model with good fit indices (CFI=0.954; TLI=0.949; RMSEA=0.068; SRMR=0.070). Internal consistency was satisfactory across subscales (ω=0.67-0.95). Correlations were consistent with theoretical expectations: higher health literacy and lower vaccine hesitancy were associated with lower endorsement of external attributions (Divine, Fate). The hierarchical second-order model (Internal, External-Powerful Others, External-Chance) yielded inadmissible solutions. Discussion. The Italian PHLOC demonstrated sound psychometric properties, supporting its validity, reliability, and measurement invariance. Future studies should further investigate higher-order structures and temporal stability to strengthen the scale’s theoretical and practical applications in research and clinical contexts.
Copyright (c) 2026 Camilla Elena Magi, Yari Longobucco, Carla Amato, Laura Rasero, Stefano Bambi, Emanuele Buccione, Khadija El Aoufy, Paolo Iovino https://creativecommons.org/licenses/by/4.0
Boredom and Health Literacy in Adolescents and Their Parents During Acute Hospitalization: Protocol for a Monocentric Observational Study
Introduction. Adolescence is a critical developmental period characterised by profound physical, psychological, and social changes. Hospitalisation for acute illness may increase adolescents’ vulnerability, particularly when care pathways are not tailored to their specific needs. Among the emotional experiences reported during hospital stays, boredom has emerged as a frequent yet understudied phenomenon in adolescents. At the same time, hospitalisation may represent an opportunity to enhance health literacy, a key competence influencing adolescents’ current and future health behaviours. Understanding the relationship between boredom and health literacy may support the development of patient-centred interventions aimed at improving the hospital experience. Methods. This is a single-centre, cross-sectional observational study conducted in the paediatric ward of Lodi Hospital (Italy). Adolescents aged 12–17 years hospitalised for acute medical or surgical conditions and one accompanying parent will be consecutively enrolled. Adolescent boredom will be assessed daily using the Multidimensional State Boredom Scale – Italian Adolescent Version, while parental boredom will be measured using the adult version of the same scale. Health literacy will be evaluated on the first day of hospitalisation using the Health Literacy for School-Aged Children (HLSAC) scale. Descriptive and inferential statistical analyses will be performed to explore predictors and associations. Results. The study is expected to provide the first quantitative evidence on boredom levels among hospitalised adolescents and their parents, as well as adolescents’ health literacy levels. Associations between boredom, health literacy, and contextual factors may emerge, identifying subgroups at higher risk. Discussion. Findings will contribute to a better understanding of the adolescent hospital experience and inform the development of targeted interventions to improve emotional well-being, engagement, and quality of care in paediatric settings.
Copyright (c) 2026 Stefano Maiandi, Iryna Zavadina, Stefania Mondini, Anna Baldo, Ester Busca, Stefania Sciglitano, Debora Guerreschi , Domenico Scognamiglio, Greta Ghizzardi, Eleonora Aloi https://creativecommons.org/licenses/by/4.0
Advanced Nursing Education in Italy and Master’s Degrees: Thirty Years of Progress in Light and Shade
Copyright (c) 2026 Valerio Dimonte, Paola Di Giulio https://creativecommons.org/licenses/by/4.0
Determinants of Career Advancement Among Medical Doctors in Italy: The Gender Gap
Introduction. Despite increasing numbers of women in medicine, they remain underrepresented in senior roles. Gender biases, lack of mentorship, work-family imbalance, and limited opportunities for advancement are among the factors that could hinder women’s career progression in the field. The study aims to investigate factors associated with the gender gap in career advancement in the medical field in Italy. Methods. A cross-sectional study was conducted through a survey among the members of the Professional Order of the Physicians and Dental Surgeons of the Province of Rome from October 2023 to February 2024, focusing on career advancement, work-family balance, workload control, and harassment. Four different career paths were identified: Academic researchers and professors (ARP), Employees (EM), Self-employed medical doctors (SE), and Physicians practicing in agreement with the NHS (PPAN). Descriptive analyses and multivariate logistic regression were run to assess factors influencing career progress and workplace experiences across various medical careers. Results. A survey of 260 physicians found significant differences in career advancement: males, older physicians, and PPAN had higher odds of career advancement. Logistic regression showed that age, gender, and career type were associated with career advancement, with gender having a borderline significant interaction with having children. Work-family balance, exhaustion, and control over work had no significant impact on advancement. Harassment was reported more by women (36.4%) than men (17.2%), particularly in the EM subgroup, and greater control over work was significantly linked to lower harassment odds. Discussion. A lower publishing rate among female academic hospital physicians and the impact of parenthood could be the reasons behind gender disparities in career progression between male and female medical doctors. Despite all other factors, being a woman is one of the most significant characteristics in shaping career progression.
Copyright (c) 2026 Elena Mazzalai, Federica Turatto, Giuseppe Furia, Aurora Heidar Alizadeh, Martina Sapienza, Maria Grazia Tarsitano , Cristina Patrizi, Giovanni Capelli , Rome OMCeO Group, Gianfranco Damiani, Corrado De Vito https://creativecommons.org/licenses/by/4.0
Emergency Department Nurses’ Experiences with the Early Care Pathway (ECP) Model: An Interpretative Phenomenological Study
Introduction. The Early Care Pathway (ECP) model was recently introduced in some emergency departments (EDs) in Northern Italy to enhance patient care through earlier nursing intervention. Although its benefits are recognized, little is known about how nurses experience and adapt to this organizational innovation. This study explores emergency nurses’ lived experiences with the ECP model, focusing on its impact on practice, professional identity, and interprofessional collaboration. Methods. A qualitative study was conducted using Interpretative Phenomenological Analysis (IPA). Seventeen nurses (12 females, 5 males; age range 24–55) with direct experience of the ECP model participated in semi-structured interviews between July and August 2024. Participants were purposively selected based on criteria including ECP training and at least three months of experience using the model. Interviews were audio-recorded, transcribed verbatim, translated into English, and analyzed following the IPA framework. Rigor was ensured through bracketing, audit trails, member checking, and triangulation. Results. Five interrelated themes emerged: (1) Deepening the nurse-patient connection – The ECP model enhanced the quality of interaction, promoting empathy, trust, and patient satisfaction through focused, uninterrupted time; (2) Empowerment and professional identity growth – Nurses reported increased autonomy, recognition, and decision-making capacity. The model reinforced their clinical judgement and enabled a more meaningful expression of their role; (3) Streamlining care through organizational innovation – ECP improved care efficiency by transforming waiting time into active care, promoting faster interventions and optimized workflows; (4) Fostering communication and team synergy – The model enhanced interdisciplinary collaboration and improved nurse-doctor dialogue. Nurses experienced more fluid team communication and greater involvement in early care decisions; (5) Navigating challenges and overcoming barriers – Implementation obstacles included resistance from physicians, ambiguity in role delineation, and workload concerns. However, most nurses expressed that these challenges were outweighed by the model’s benefits. Conclusion. The ECP model has a transformative impact on emergency nursing, fostering deeper patient relationships, enhancing professional identity, streamlining care, and strengthening teamwork. While implementation challenges exist, nurses overwhelmingly view the model as a valuable innovation that enriches both patient care and their professional experience. Understanding these lived experiences is essential for guiding future implementations and addressing contextual barriers.
Copyright (c) 2026 Sihame Haoufadi, Luca Guardamagna, Orejeta Diamanti, Tiziana Nania, Maria Gloria Modena, Giovanna Artioli, Federica Dellafiore https://creativecommons.org/licenses/by/4.0
Urinary Incontinence: Lived Experience of Adult Women. A Phenomenological Study Protocol
Introduction. Urinary incontinence is a common yet underreported condition among women, affecting up to 69% but often hidden due to stigma. While various treatments exist, women’s help-seeking and self-management are shaped by personal beliefs, emotions, and cultural context. In Italy, access to services, informal networks and the sensitivity of intimate health topics may influence how women perceive, talk about, and manage urinary incontinence. Objective. Explore, within an Italian context, the lived experience of adult women with urinary incontinence, focusing on how they interpret and make meaning of their condition, their daily coping strategies, emotional responses, and the complex factors shaping their engagement with care. Methods and Analysis. This qualitative phenomenological study will use Interpretative Phenomenological Analysis (IPA). Participants attending pelvic floor rehabilitation at an outpatient clinic in Northern Italy will be purposively sampled. Data will be collected through semi-structured interviews and socio-demographic questionnaires until interpretative sufficiency is reached. Audio recordings will be transcribed verbatim and analysed by the researchers, both manually and with NVivo. Reflexivity, double coding, triangulation, and an audit trail will be employed to ensure trustworthiness. Ethical approval has been obtained, and informed consent will be secured from all participants. Expected Results. The study will highlight psychosocial aspects often overlooked in care, informing person-centered, flexible interventions to improve patient engagement and adherence. It will support efforts to reduce stigma, promote timely help-seeking, and enhance healthcare professionals’ empathy and communication skills. Limitations include exclusion of women not engaged in rehabilitation and the sensitive nature of the topic, which may affect participant openness.
Copyright (c) 2026 Sara Trapani, Giulia Villa, Debora Rosa, Ilaria Baini, Stefania Rinaldi, Stefano Salvatore, Massimo Candiani, Duilio Fiorenzo Manara https://creativecommons.org/licenses/by/4.0
Clinical Nursing Care for Pediatric Patients with Myelomeningocele: A Scoping Review Protocol
Introduction. Myelomeningocele (MMC) is an open spinal dysraphism characterized by a neural tube defect in which the spinal cord, nerves and meninges protrude through a skin defect, predominantly in the lumbosacral region. Nursing care is essential in the early management of affected newborns, encompassing monitoring, prevention of complications, family support, and interdisciplinary coordination to ensure continuous care. Objective. This scoping review aims to systematically map the available literature on hospital-based nursing care for pediatric patients with MMC and identify knowledge gaps in order to provide an up-to-date overview of the state of the art and to suggest areas for future research. Methods and Analysis. This protocol follows the PRISMA-ScR guidelines. The review will include primary research studies, clinical guidelines, and expert opinions published in English and Italian, without time restrictions. We will search PubMed/MEDLINE, CINAHL, Web of Science, Scopus, Cochrane Library, OpenGrey, and Google Scholar. Two independent reviewers will conduct screening and data extraction using Rayyan. Data will be synthesized thematically and presented in tabular and narrative formats. Expected Results. Preliminary evidence highlights three main pillars in the management of myelomeningocele: prevention of complications, optimization of functionality, and enhancement of patient well-being. A multidisciplinary approach is essential to address the complex needs of neonates with MMC, with nurses playing a key role in coordinating care, ensuring continuity, and monitoring clinical status. Current recommendations emphasize specific nursing interventions for early care, including protective positioning, sterile dressing techniques, and allergen avoidance. However, despite the presence of some guidance, perioperative nursing practices remain underexplored in the literature. This review aims to identify, map, and summarize existing evidence to support and improve clinical nursing care for pediatric patients with MMC. Ethics and Dissemination. Ethical approval is not required for this review. Findings will be submitted for publication in a peer-reviewed journal and disseminated through academic conferences and institutional training. Protocol Registration. osf.io/rnc9u
Copyright (c) 2026 Carlotta Zanetti, Chiara D'Orazio, Federico Cortese, Emanuele Bascelli, Angela Peghetti https://creativecommons.org/licenses/by/4.0
Learning Through Adversity: An Interpretative Phenomenological Study on Nursing Students’ Experiences in Intensive Care Units
Introduction. Large-scale healthcare emergencies have profoundly reshaped nursing education, particularly its experiential and clinical components. The reorganization of clinical placements and the integration of nursing students into Intensive Care Units (ICUs) dedicated to COVID-19 patients exposed students to highly complex, technologically advanced, and emotionally demanding care environments. Understanding how students experienced these placements is essential to inform educational strategies that ensure both learning and well-being in crisis contexts. Methods. A qualitative study was conducted using an Interpretative Phenomenological Analysis (IPA) approach to explore nursing students’ lived experiences during ICU placements in a large-scale healthcare emergency. Eight third-year undergraduate nursing students who had completed at least 15 days of internship in medical or surgical ICUs participated in semi-structured, in-depth interviews. Data were analysed following the IPA methodological framework, allowing for an in-depth exploration of shared meanings and individual sense-making processes. Results. Four interconnected themes emerged from the analysis: (1) Evolution of Feelings and Emotions, describing an initial phase of fear, uncertainty, and emotional strain; (2) Challenging Reality, reflecting exposure to critically ill patients and high-intensity care; (3) Going on Side by Side, highlighting the central role of relational support from clinical tutors, healthcare teams, and family members; and (4) Deep Growth, representing the development of professional confidence, resilience, and reflective capacity. Over time, students reframed distressing experiences into meaningful learning opportunities. Discussion. Despite the psychological and emotional challenges associated with ICU placements during a healthcare emergency, students reported substantial personal and professional growth when adequate support was present. These findings underscore the importance of structured mentorship, emotional support, and reflective spaces within clinical education. Integrating such elements into nursing curricula may better prepare students to navigate high-pressure clinical environments while safeguarding their well-being and fostering professional identity development.
Copyright (c) 2026 Federica Dellafiore, Luca Guardamagna, Lorenzo Casole, Gloria Modena, Orejeta Diamanti, Tiziana Nania, Alessandro Delli Poggi, Giovanna Artioli https://creativecommons.org/licenses/by/4.0
Virtual Reality Interventions for Anxiety and Pain Management in Pediatric Healthcare: A Scoping Review Protocol
Introduction. Anxiety and pain are common in pediatric patients undergoing healthcare procedures, with potential short- and long-term consequences. Virtual reality (VR), including immersive and non-immersive modalities, is increasingly used as a non-pharmacological intervention; however, the available evidence is heterogeneous and fragmented. Objective. This scoping review aims to systematically map the characteristics, contexts, and reported outcomes of VR interventions for the management of anxiety and pain in pediatric healthcare settings. Inclusion criteria. This review will consider studies involving pediatric populations (0–18 years) exposed to VR interventions (immersive, semi-immersive, or non-immersive) for anxiety and/or pain management in healthcare contexts. Methods. This protocol follows the PRISMA-ScR guidelines and the Arksey and O’Malley framework, refined by Levac et al. A comprehensive search will be conducted in MEDLINE (PubMed), Scopus, and Web of Science, along with grey literature sources. Two independent reviewers will perform study selection and data charting using a standardized extraction form. Extracted data will include study characteristics, population details, VR type and devices, clinical settings, intervention features, and outcomes. Data synthesis. Results will be synthesized descriptively using tables and figures to map the evidence. A narrative synthesis will be conducted to summarize key findings, identify patterns across VR modalities, populations, and settings, and highlight knowledge gaps. Where appropriate, findings will be stratified by age group, type of VR intervention, and clinical context.
Copyright (c) 2026 Fabrizio Faina, Gian Domenico Giusti https://creativecommons.org/licenses/by/4.0
The Objective Structured Clinical Examination as an Assessment Tool in the Bachelor’s Degree Courses for Health-Care Professions: A Scoping Review
Introduction. The increasing complexity of healthcare requires health professionals to achieve high levels of competence. Universities are therefore called to adopt assessment methods that effectively support the development of clinical abilities. The aim is to describe the use of the Objective Structured Clinical Examination (OSCE) as an assessment method within bachelor’s degree programmes in the health professions. Methods. A literature search was carried out in PubMed/MEDLINE, Scopus, CINAHL and grey literature (December 2024–October 2025) following Joanna Briggs Institute (JBI) methodology. Results. Nineteen studies, published between 2000 and 2025, were included from 4,926 identified records. The OSCE is reported as a valid and reliable method for assessing clinical, communicative and relational competencies, with a strong perceived educational impact across undergraduate health professions programmes. Advantages over traditional assessment methods include greater fairness, transparency and objectivity. Reported limitations, often associated with students’ anxiety and stress, include inadequate planning and insufficient preparation. Discussion. The OSCE is a reliable and fair tool for the structured assessment of clinical competencies. Students perceive it as an educational, motivating and realistic experience. Further studies are needed to explore its application in other health professions and to document implementation processes in programmes where the OSCE is already in use.
Copyright (c) 2026 Elisa Spaziani, Manuela De Rosa, Angela Peghetti, Stefano Durante, Silvio Quirini https://creativecommons.org/licenses/by/4.0
Creative Drama in Developing Communication Skills: The Bidirectional Effects of a Service-Learning Program Implemented by Nursing Students
Introduction. Drama-based education and service-learning have shown potential for promoting adolescents’ communication and socio-emotional competencies. This study aimed to examine changes in middle school students’ communication skills following a creative drama–based service-learning program and to explore the experiences of nursing students who implemented the program. Methods. A single-group pretest–posttest quasi-experimental design was used. Nursing students delivered a 120-minute creative drama session to seventh- and eighth-grade students at a public middle school in Istanbul. The sample consisted of 81 students (M = 12.50, SD = 0.60; 53.1% female). Communication skills were assessed using the Communication Skills Scale (CSS) before and after the intervention. Nursing students’ experiences were explored through semi-structured interviews and analyzed using thematic analysis. Results. Posttest CSS scores were higher than pretest scores (Z = −7.51, p < .001, r = .83). Female students had higher communication skills scores than male students (U = 546, p = .010, r = .33). Thematic analysis revealed six themes: personal growth, stronger communication awareness, reduced stage anxiety, improved teamwork, increased professional motivation, and initial challenges and suggestions for improvement. Conclusion. Short-term creative drama–based service-learning programs may help enhance middle school students’ communication skills while also providing meaningful personal and professional learning experiences for nursing students.
Copyright (c) 2026 Nurten Arslan Işık, Dılşa Azizoğlu Keleş, Aynur Aytekin Özdemir, Ayşe Okanlı, Merve İnan Budak, Nesrin İlhan, Furkan Keleş, Büşra Kütük Kurt, Özge Şanlıtürk https://creativecommons.org/licenses/by/4.0
Oral Mucositis in Patients Undergoing Haematopoietic Stem Cell Transplantation: A Retrospective Analysis
Introduction. Oral mucositis (OM) is a prevalent and debilitating complication in patients undergoing haematopoietic stem cell transplantation (HSCT), particularly following high-dose chemotherapy and total body irradiation. Despite its clinical significance, observational data on OM incidence, severity, and associated factors in HSCT recipients remain limited. This study aimed to evaluate the clinical presentation of OM, its severity, and related outcomes during hospitalisation. Methods. A retrospective observational study was conducted at La Maddalena Cancer Center, Palermo, Italy, including 211 patients who underwent HSCT between January 2018 and December 2020. OM severity was assessed using the World Health Organization Oral Toxicity Scale. Data on demographic and clinical characteristics, total par-enteral nutrition (TPN), hospital stay, and oral care protocols were systematically extracted. Associations between OM severity and relevant variables were analysed using non-parametric tests and Spearman’s correlation. Results. Post-transplantation, nearly all patients developed OM, with a median severity grade of 2.0 (IQR: 2.0–3.0). Male patients experienced significantly more severe OM than females (p = 0.01). Mucositis severity correlated modestly with hospital stay duration (ρ = 0.15, p = 0.03), and strongly with the number of TPN days (ρ = 0.50, p < 0.001). A significant association was also observed between OM and nausea severity (ρ = 0.20, p = 0.003). No significant correlations were found with age or educational level. Discussion. OM remains a high-impact complication in HSCT, associated with nutritional impairment and pro-longed hospitalisation. These findings highlight the importance of comprehensive oral care protocols and underscore the need for targeted, sex-sensitive interventions and prospective multicentre research.
Copyright (c) 2026 Antonio Giambrone, Mattia Bozzetti, Marcella Dabbene, Gianluca Albegiani, Pietro Sparacino, Alessio Lo Cascio, Daniele Napolitano, Orejeta Diamanti, Simone Amato, Michela Piredda https://creativecommons.org/licenses/by/4.0
Connecting Disciplines, Transforming Health: The Vision of the Interdisciplinary Journal of Nursing and Health
Copyright (c) 2025 © The Author(s) 2025. https://creativecommons.org/licenses/by/4.0
Evolving Competences of Nurse Mentors in Clinical Education: A Mini-Review of Recent International Evidence
Introduction. Clinical mentoring plays a crucial role in nursing education, contributing to the development of students’ technical, relational, and critical skills. Mentor competence is a key determinant of the quality of the clinical learning experience. In this perspective, the aim of this work is to synthesize evidence on nurse mentors’ self-assessed competence, with particular focus on strengths, areas for improvement, and effective educational interventions. Methods. This mini-review was based on the updated literature search (PubMed, CINAHL, Scopus) covering the period 2020–2025. Quantitative and mixed-method studies conducted in real clinical settings, with direct measurement of mentors’ self-perceived competence, were included. Results. Pedagogical and personal competencies were perceived as strong, whereas organizational skills were less developed. Structured educational programs significantly improved self-assessed competence scores and observed performance. Intercultural competence emerged as a critical area. Discussion. Improving mentors’ competence requires an integrated approach that combines continuous training, standardized assessment tools, the development of intercultural skills, and organizational support..
Copyright (c) 2026 Gian Domenico Giusti, Stefano Bambi, Yari Longobucco, Rocco Mazzotta https://creativecommons.org/licenses/by/4.0
Nursing-Led Interventions to Enhance Post-Bariatric Quality of Life: A Literature Review
Introduction. Bariatric surgery is a critical intervention for morbid obesity, yet 30-day hospital readmission rates remain a significant challenge for patient’s quality of life and healthcare sustainability. Despite its relevance, a scientific gap remains regarding the synthesis of nursing-led management models. This review aims to identify and categorize clinical and psychosocial predictors and causes of readmission and describe nursing-led interventions and organizational strategies designed to reduce the healthcare burden. Methods and Materials. A structured narrative review was conducted following SANRA guidelines. Based on a PICO framework, a search was performed across MEDLINE, Embase, and CINAHL databases between February - October 2024, with an integrative update conducted in December 2025. The review included studies published from January 2014 to December 2025. Inclusion criteria focused on studies describing specialized nursing interventions and outcomes like readmission or reoperation. Two independent reviewers performed the screening, resolving discrepancies via third party consensus. Results. A total of 32 articles were included. Major predictors for readmission include a preoperative BMI >45 kg/m², surgical technique and low socioeconomic status. The most frequent clinical causes are often preventable, including abdominal pain, nausea, vomiting, and dehydration. Major nursing strategies include structured patient education, specialized bariatric nursing, and digital health tools for proactive monitoring. Nurse case management emerged as a core strategy for coordinating multidisciplinary care Discussion. Preventing readmissions requires an analytical shift toward nursing-led risk stratification and proactive surveillance. Specialized nurses and case managers act as strategic bridges to healthcare equity, overcoming socioeconomic and geographical barriers. Implementing autonomous nursing roles is essential for the long-term sustainability of bariatric programs, ensuring both clinical excellence and equitable care distribution, optimizing outcomes, improving patients’ quality of life and reducing hospital readmission rates.
Copyright (c) 2026 Jesus Francisco Javier Leon Garcia, Alessia Sorrenti, Chiara Carioni, Myriam Neglia, Roberto Accardi https://creativecommons.org/licenses/by/4.0
Investing in Young Nurses Worldwide: If Not Now, When? The Importance of Promoting the New Generations in the Healthcare System
Stoma and peristomal complications: a rapid overview of the literature
Complications of the stoma complex are estimated to occur in 20-70% of the ostomized population. These studies, however, appear to show contradictions in terms of definitions of the same complications, making the results of the analyses of incidence and prevalence of the phenomenon inconsistent with each other. The absence of clear and unambiguous definitions, does not allow clear evidence to be defined in science; moreover, this is reflected in the absence of a standardized clinical-care approach, which inevitably hinders the spread of an organizational and methodological culture aimed at the wellness and autonomy of the subject. In order to overcome this obstacle, different classifications of complications have been proposed throughout the years, differentiating these exclusively into macro categories, without delving into them in detail. In this regard, this review aims to clearly define, from the general to the particular, the individual complications of the stoma complex so as to provide nurses an instrument that can help them in the prevention and recognition of these.
Copyright (c) 2023 infermieristica journal
The use of wireless technology for thoracic physical examination: a pilot case based on a literature review
Auscultation is a standard method of physical examination used by physicians and is widely accepted by doctors and patients for its simplicity, repeatability and non-invasiveness. Artificial intelligence is the 'new integrated frontier' of the thoracic examination, yet there are still concordance discrepancies in obstructive pulmonary diseases; on the contrary, for fibrotic diseases, the degree of concordance increases significantly, as shown by previous clinical studies conducted mainly in children. However, there are data in the literature that appear to be very discordant on certain types of lung noises, such as wet crackles and dry noises; therefore, the application of these devices in daily use in outpatient and hospital settings needs to be further expanded. The integrated data allowed us to make the right diagnosis, also avoiding costs for the national health system and possible invasive procedures such as bronchoscopy, which today remains the “gold standard” for the histological diagnosis of sarcoidosis with lung localisation. Integrated technology could improve the diagnostic capacity in restrictive lung diseases, as shown in this clinical case. Several randomised controlled trials are still needed to increase the significance of this initial integrated research work performed
Copyright (c) 2023 Marco Umberto Scaramozzino, Giovanni Sapone, Ubaldo Romeo Plastina, Guido Levi , Mariacarmela Nucara , Maura Festa https://creativecommons.org/licenses/by/4.0
Blue Light Photobiomodulation as treatment for peristomal skin disorders: case series
Introduction. Keeping the peristomal skin intact proves to be a challenge for stoma patients and the health care teams that work with them. Peristomal skin complications are shown to affect 36.3% to 73.4% of patients. They are often particularly difficult to treat with topical therapies since the topical medications available are cream-based or ointment type formulations that don’t allow for perfect adhesion of the pouching system to the abdomen’s skin. In this study a preliminary evaluation of the effectiveness of Blue Light Photobiomodulation in the treatment of peristomal skin disorders was performed Methods. Patients carrying ostomy with lesions of types L2, L3, L4, L5, LX (SACS 2.0 classification5) that had not experienced an improvement in 4 weeks of standard therapy were selected for Blue Light therapy. Blue Light treatment was performed twice a week for 4 weeks, in addition to standard therapy. Tissue repair was evaluated through Wound Bed Score and pain reduction. Results. All the 11 patients enrolled responded to Blue Light treatment with an average WBS improvement of 8.3 points and a significant reduction in pain. Blue Light Photobiomodulation proved decisive in activating the healing process in three patients with pyoderma gangrenous. Conclusions. The positive clinical results suggests that Blue Light Photobiomodulation could be a promising tool in the management of peristomal skin lesions.
Copyright (c) 2023 infermieristica journal https://creativecommons.org/licenses/by/4.0
The foot has 28 bones, 30 joints, and more than 100 muscles, ligaments, and tendons. These structures work together to carry out two main functions: weight-bearing and propulsion. Plus, the foot must be flexible to adapt to uneven surfaces and remain stable. In this article, we briefly illustrate the anatomy of the foot and its various structures
Copyright (c) 2022 infermieristica journal https://creativecommons.org/licenses/by/4.0
Emergency Department Boarding: An Inevitable Phenomenon or Crucial Quality Indicator?
EDUcation, HEalth Literacy and Stroke in European countries: EDUHELP Project
Objectives. The EDUSTROKE project aims to (1) assess stroke-related health literacy (HL) in the general populations of Albania and Italy and identify sociodemographic and behavioral determinants of low HL, and (2) linguistically and psychometrically validate stroke-related HL questionnaires for cross-cultural use in both countries. Trial Design. This is a cross-sectional, two-phase, multicentre observational study. Phase 1 consists of a population-based survey to estimate levels and determinants of stroke-related HL. Phase 2 focuses on the linguistic, cultural, and psychometric validation of the instruments, following COSMIN and SPIRIT recommendations for measurement studies. Participants and Settings. Approximately 1,000 adults (≥18 years) will be recruited in each country using a stratified convenience sampling approach with quota targets for age, sex, geographic region, and urban–rural residence. Participants will be recruited in public settings and through an online survey. Healthcare professionals and individuals unable to provide informed consent will be excluded. Interventions. This is an observational study with no clinical intervention. Participants will complete a structured questionnaire including a sociodemographic survey, the Stroke Knowledge Test, the Awareness of Stroke Symptoms and Risk Factors Questionnaire, and the Stroke Risk Factor Knowledge and Perception Questionnaire. Questionnaires will undergo forward–backward translation, cognitive pretesting, and expert content validation. Primary and Secondary Outcomes. The primary outcome is a latent stroke-related HL score derived from confirmatory factor analysis of combined questionnaire items. Secondary outcomes include identification of HL predictors through weighted multivariable regression models and evaluation of psychometric properties (content validity, reliability, factor structure, and measurement invariance across countries). Conclusions. EDUSTROKE will provide population-level evidence on stroke-related HL in two European countries with differing healthcare contexts and deliver validated tools for cross-national HL assessment, supporting future public health education and prevention strategies.
Eye Care Practice in Intensive Care Units: A Rapid Review
Introduction. Ocular Surface Diseases (OSDs) are frequent yet often under-recognised complications in sedated and mechanically ventilated Intensive Care Unit (ICU) patients, in whom impaired eyelid closure and reduced tear film protection promote their development during critical illness. Although these conditions can significantly affect visual function and post-discharge quality of life, ocular care receives inconsistent attention in routine clinical practice. This rapid review aimed to identify and synthesise evidence-based nursing practices for the prevention and management of OSDs in the ICU within this patient population. Methods. A rapid review was conducted between February and August 2024 and registered in PROSPERO (CRD42024540825). Searches were carried out in MEDLINE, CINAHL, Embase, and Google Scholar for full-text studies published in English between 2014 and 2024 that involved adult ICU patients receiving nurse-delivered ocular interventions. Methodological quality was appraised using the Joanna Briggs Institute critical appraisal tools. Given the heterogeneity of study designs and outcomes, a narrative synthesis was undertaken. Results. Fourteen studies (n = 1,322 patients) from six countries met the inclusion criteria; most were randomised controlled trials (64%), and 72% were rated as having high methodological quality. Interventions included the application of preservative-free lubricants, vitamin A–based ointments, moisture chambers, polyethylene covers, eyelid taping, and structured nurse-led protocols. Moisture chambers and ointments demonstrated the strongest protective effects against exposure keratopathy, while the implementation of protocols and targeted nurse education significantly reduced ocular morbidity. Discussion. The findings reaffirm the central role of ICU nurses in preventing OSDs through timely, evidence-based interventions. Standardising eye care practices may substantially reduce complications and enhance long-term visual outcomes. Further high-quality multicentre studies are required to refine recommendations and support broader clinical implementation.