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Background: Reminders via digital technology offer a novel and efficient means to address medication forgetfulness, as they are easily accessible and user-friendly for patients. In particular mobile text message reminders are more suitable for chronic patients, as they require few technical skills, can operate without internet connectivity, and are less expensive than other technologies. This study aimed to assess the intention to use mobile text message reminders for medication adherence among hypertensive patients at the Gondar City health facilities. Methods: A facility-based cross-sectional study was conducted. A simple random sampling method was used to select 423 hypertensive patients. Data was collected from April 1 to May 15, 2023. Data was collected using Kobo Toolbox, and the collected data was exported to MS Excel. Subsequently, the data was imported and analyzed using the SPSS version 20. Binary and multivariable logistic regression analysis was employed to assess factors associated with the outcome variable. Result: The finding indicates that 64.5% of the patients have an Intention to use mobile text message reminders for medication adherence. Perceived usefulness (AOR = 2.53: 95%CI: 1.41, 4.52), perceived ease of use (AOR = 3.28: 95% CI: 1.81, 5.95), forgetting to take medication (AOR = 2.20: 95%CI: 1.38, 3.50) and patient holds their mobile phone always (AOR = 1.96: 95%CI: 1.04, 3.68) were associated factors with outcome variable. Conclusion: Forget taking medication, the patient holds their mobile phone always, Perceived ease of use and Perceived usefulness were significantly associated with the outcome variable. We recommend designing and implementing user-friendly text message reminder systems and educating hypertensive patients about the system's benefits. [ABSTRACT FROM AUTHOR]

Introduction: The increasing smoking population in Africa necessitates intensified tobacco cessation services. Assessing nicotine dependence with tools such as the heaviness of smoking index (HSI) aids in cessation efforts. This study evaluated the association between HSI and quit attempts and quit intentions among African cigarette smokers. Methods: Global Adult Tobacco Survey (GATS) data from eight African countries collected between 2011 and 2018 were analysed. The time to first smoke (TTFS) and number of cigarettes per day (CPD) were used to estimate the HSI score and dependence level. The association between HSI dependence level and quit attempts and quit intentions was evaluated using likelihood ratios (LR). Results: Among 2,399 daily cigarette users, 1,618 (67.5%) were exclusive cigarette users. The average and median CPDs were 8.27 ± 8.3 and 5 (IQR: 2–18), respectively, with Ethiopia having the highest mean CPD (11.6). In Ethiopia, 51.5% of exclusive and 42% of nonexclusive users had low dependence (HSI < 2), whereas 43.9% and 31.3% of other African countries had low dependence. The association between low dependence and quit attempts was significant only for exclusive cigarette smokers in Ethiopia, with LR of 1.45 (95% CI: 1.08–1.93). The association between low dependence and quit intentions was significant in Ethiopia for both exclusive (LR = 1.42) and nonexclusive (LR = 1.53) users. None of the LR estimates were > 10 or < 0.1. Conclusion: The association between low dependence (HSI < 2) and quit behaviour was limited in African settings, highlighting the complex interplay between usage patterns, dependence assessment, and quit behaviour. A contextual tool for assessing nicotine dependence tailored to African settings is warranted for effective smoking cessation. [ABSTRACT FROM AUTHOR]

Background: The aim of this study was to determine the role of suicide literacy, suicide stigma, perceived social support, and attitudes toward seeking professional psychological help (ATSPPH) in predicting general help-seeking intention among individuals who have attempted suicide by structural equation modeling. Methods: This cross-sectional study was conducted among 462 people who were referred to the hospital due to suicide attempt in one of the cities of eastern Iran in 2023. The sampling method in this study was consecutive sampling. The Pearson correlation, One-way ANOVA, and Independent-samples t-test were used to analyze data by SPSS software. Also, AMOS software was used for conducting structural equation modeling and checking the standardized direct effects and standardized indirect effects between variables. Results: Only 0.9% (n = 4) of participants answered correctly more than 17 questions regarding suicide literacy. The structural equation modeling (SEM) results showed that suicide literacy, suicide stigma, perceived social support, and ATSPPH predicted 51% variance in the general help-seeking intention (R2 = 0.51, PGFI = 0.607, PCFI = 0.568, RMSEA = 0.064). The variables of suicide literacy (estimate total effect = 0.615), ATSPPH (estimate total effect = 0.368), perceived social support (estimate total effect = 0.123), and suicide stigma (estimate total effect = 0.033) had the greatest impact in predicting the general help-seeking intention. Conclusion: The SEM results highlight the importance of paying more attention to suicide literacy, reducing suicide stigma, promoting social support, improving the positive attitude toward mental health services, encouraging people who have attempted suicide to seek psychological help, and finally preventing suicide attempt. [ABSTRACT FROM AUTHOR]

Background: The global nursing shortage, driven by high turnover rates, significantly impacts healthcare quality. Workplace psychological violence severely affects nurses' mental health and job satisfaction, leading to increased turnover. Despite extensive research on workplace violence, the specific impact of psychological violence on nurses' turnover intentions remains insufficiently explored. This study investigates the mediating role of job satisfaction in the relationship between workplace psychological violence and nurses' turnover intentions. Methods: A workplace psychological violence scale, a job satisfaction scale, and a turnover intention questionnaire were utilized to survey 206 clinical nurses in a tertiary-level hospital in Guangzhou City. The study employed a convenience sampling method. Statistical analyses included correlation, mediation analyses., descriptive statistics, multivariate linear hierarchical regression analyses, Pearson correlation analyses, and structural equation models. Results: Clinical nurses reported a workplace psychological violence score of 0.97 ± 0.79, job satisfaction of 3.16 ± 0.58, and turnover intention of 2.22 ± 0.92. Workplace psychological violence was negatively correlated with job satisfaction (r = -0.516, P < 0.01) and positively correlated with turnover intention (r = 0.418, P < 0.01). Turnover intention was negatively correlated with job satisfaction (r = -0.477, P < 0.01). Mediation analysis indicated that Job satisfaction partially mediated the association between workplace psychological violence and turnover intention. The total effect (β = 0.489) of workplace psychological violence on turnover intention included its direct effect (β = 0.274) and the indirect effect mediated through job satisfaction (β = 0.215), with the mediating effect accounting for 43.97% of the total effect. Conclusions: Workplace psychological violence directly predicts nurses' turnover intention, with job satisfaction serving as a mediator in this relationship. Healthcare managers can mitigate psychological violence by improving mental health support, work environments, and organizational culture to enhance job satisfaction and reduce nurse turnover. [ABSTRACT FROM AUTHOR]

Background: Fertility rates have been decreasing both worldwide and in China. Although current policies have been aimed at raising the birth rate in China, their overall effects have been unclear. Therefore, exploration of fertility intention and related influencing factors is crucial. Methods: This study used a convergent parallel mixed methods combining descriptive and cross-sectional designs with a framework analysis. Convenience sampling was used to select mothers of childbearing age with two children (n = 603), living in Guangdong Province, China. Participants completed an online questionnaire investigating sociodemographic characteristics, as well as determinants and attitudes regarding the third-child fertility intention. Correlation coefficients and multivariate regression analyses were used to present quantitative findings. Eleven interviews were conducted, and a framework analysis method was used for data analysis. The results for the qualitative and quantitative study components were analyzed separately and were subsequently integrated through side-by-side comparison and joint display. Result: Attitudes toward fertility intention were negative, and the rate of fertility intention was 10.4% in Guangdong Province. In the quantitative component, women's age, perceived value of having a third child, and attitudes were found to be factors promoting the intention to have a third child, whereas monthly family income, grandparents' health status, and policy support were found to be factors hindering the intention to have a third child. Four major themes emerged regarding the perceptions and experiences regarding fertility intention in the qualitative component. After integrated analysis, younger age, knowledge regarding policy support, and access to childcare support were found to be factors significantly affecting the intentions of mothers with two children regarding having a third child. Conclusion: Fertility issues require continued attention. Our findings provide a reference for optimizing existing policies to increase fertility intentions. Providing policy support, such as public childcare support, flexible working hours for mothers, affordable childcare, and greater psychological support, would enable mothers to improve their parenting. In addition, increasing the dissemination of knowledge regarding policies is necessary to improve the level of public understanding and promote fertility intention. [ABSTRACT FROM AUTHOR]

Background: Turnover intention (TI) indicates an employee's intention to depart from their current role within a defined timeframe. In China, the Targeted Admission Medical Education (TAME) program, initiated in 2010, offers tuition-free education to cultivate rural doctors. Despite continuous professional development (CPD) being considered a viable retention strategy, TI of alumni doctors from the TAME program remains high in recent years. This study aims to describe the prevalence of "turnover intention" among alumni doctors of the TAME program doctors in rural placements, and associated factors that predict high turnover intention. Methods: A snowball sampling method was adopted to collect survey responses from 1,369 alumni doctors of the TAME program in Jiangxi Province, China. Based on the survey data, a binary variable was constructed to measure the turnover intention, and multivariate binary logistic regression models were used to investigate the relationship between doctors' turnover intention and demographic characteristics, work environment characteristics, and CPD activities. Results were presented using adjusted odds ratios with 95% confidence intervals. Results: Among the 1,369 alumni doctors of the TAME program surveyed in this study, 392 (28.6%) expressed intentions to leave their current positions. Of the respondents, 620 (45.3%) were female, and 930 (67.9%) were married. Additionally, 1,232 respondents (90%) indicated that their fathers were engaged in farm work. Strong associations with turnover intention were notably found among individuals who had undergone training at a higher-level healthcare institution for more than three months (aOR = 6.810, 95% CI: 3.333 to 13.909, p-value < 0.001), particularly those who had participated in CPD through a graduate degree program (aOR = 1.818, 95% CI: 1.272 to 2.597, p-value < 0.001). Conclusion: Rural doctors in China from the tuition-free medical education program exhibit high turnover intention, especially those in graduate degree programs as CPD. To retain these highly qualified rural doctors, it is vital to offer competitive efficiency wages aligned with their skills and provide ample long-term career growth opportunities within the rural healthcare system. Highlights: Retaining rural doctors in China who graduated from the tuition-free medical education program continues to pose a significant challenge. High turnover intention is particularly prevalent among those enrolled in CPD graduate degree programs. Offering competitive efficiency wages and creating abundant long-term career growth opportunities within the rural healthcare system are essential measures. [ABSTRACT FROM AUTHOR]

Background: Social distancing is a key behavior to minimize and controlling COVID-19 infections. The current study applied an integrated Theory of Planned Behavior to identify the determinants of social distancing behavior, and the processes involved, in the context of the COVID-19 pandemic. Methods: a cross-sectional study was conducted in Southern Iran among 1000 people from Shiraz by employing a convenience sampling technique. Data were collected using a pre-tested and structured questionnaire based on the main constructs of the Theory of Planned Behavior. Statistical analysis was done using IBM SPSS software version 22 and Amos version 24. Level of statistical significance was declared at a P-value of less than 0.05. Results: according to the results, the subjective norms (F = 2.696, effect size = 0.139) and attitude (F = 3.582, effect size = 0.155) play an important role in the samples’ PBC (P ≤ 0.05). Final adjusted structural equation model of the effects of independent variables (Gender, subjective norms, attitude) on samples’ intention to adherence social distancing for prevention of Covid-19 with the mediating role of one main variable of PBC. The PBC alone can be an important factor in creating intensive behavior in the samples (F = 3.560, effect size = 0.18). Conclusion: current findings highlight the importance of “attitude, subjective norms and PBC” as determinants of social distancing intention. Future research on long-range predictors of social distancing behavior and reciprocal effects in the integrated model is warranted. This evidence is relevant to public and private organizations in the process of developing strategies to promote and engage the population in adopting the behavior of “Adherence to Social Distancing” in Iran. [ABSTRACT FROM AUTHOR]

Background: Female Genital Mutilation/Cutting (FGM/C) is a form of gender-based violence that has negative health consequences. The decision to perform FGM/C is often made collectively and a variety of actors influence the decision. There is inconsistent and inconclusive evidence that health education interventions lead behavioural changes related to FGM/C among key decision-makers. Therefore, the aim of this systematic review and meta-analysis was to examine the effectiveness of health education interventions on decision-makers intentions not to perform FGM/C in the future. Methods: A systematic review and meta-analysis were performed according to the Preferred Item for Systematic Review and Meta-analysis (PRISRMA) guideline. Studies were obtained from databases such as PubMed, Google Scholar, EMBASE, CINAHL, Cochrane, African Journals Online and relevant lists of identified studies (interventional studies related to FGM/C among key decision-makers). Unpublished sources and organizational websites were also searched for relevant articles. The quality of studies was assessed using the Quality Assessment Tool for Quantitative Studies developed by the Effective Public Health Practice Project's. The meta-analysis was carried out using STATA.17 and Review Manager 5.3 software. Heterogeneity and publication bias were assessed using the I2 statistic and funnel plot, respectively. The pooled effect size with a 95% confidence interval was presented using a forest plot and random effect model. Results: This meta-analysis included nineteen studies with a total of 13,326 study participants. The overall pooled relative risk of intention not to perform FGM/C in the future was 1.55 (95% CI;1.24, 1.94). In the subgroup analysis, the effect of health education on intention not to perform in the future was higher in studies that used both health education and other interventions (RR = 3.75, 95% CI; 2.04, 6.88) compared to those using only health education (RR = 1.35, 95% CI; 0.95, 1.92). Studies with longer intervention duration (above 12 months) had a greater effect on intention not to perform (RR = 1.34, 95% CI; 0.86, 2.09) compared to studies with a short intervention period (6–12 months) (RR = 1.14, 95% CI; 0.61, 2.15). Conclusion: This review examined the impact of health education on key decisions-makers' intention not to perform FGM/C in the future. Although the pooled effect size estimate may have been influenced by heterogeneity, the results suggest that education about FGM/C has a positive influence on the intentions of key decision-makers. It is recommended that health education interventions target local decision-makers such as religious and clan leaders and include them in initiatives aimed at preventing and eliminating FGM/C. PROSPERO registration number: CRD42024542541. [ABSTRACT FROM AUTHOR]

Background: Globally, the issue of high nurse turnover rates is prevalent in China. The COVID-19 pandemic exacerbated the attrition rate of nurses. Turnover intention is the most reliable predictor of nurse turnover. However, there is currently a lack of proper evaluation tools in China. This study aimed to translate the Nurses Turnover Intention Scale (NTIS) into Chinese and examine the psychometric characteristics of the Chinese version of the NTIS among clinical nurses in China. Methods: Approximately 418 nurses were recruited from three tertiary general hospitals in Jiangxi, Guangdong, and Zhejiang provinces. This study used Brislin's double-back translation, back-translation, and cross-cultural adaptation methods to translate the scale. Internal consistency, split-half reliability, and test-retest reliability were used to measure the reliability of the Chinese scale version. The validity of the Chinese scale version's content was evaluated via the Delphi method. Exploratory and confirmatory factor analyses were carried out to evaluate the construct validity of the Chinese scale versions. In exploratory factor analysis, principal component analysis and maximum variance rotation method were used in this study. In the confirmatory factor analysis, Amos 24.0 software was used for analysis. Results: The NTIS in Chinese has ten elements: a Cronbach α coefficient of 0.864, a Cronbach α coefficient of 0.852∼0.903 for the three dimensions, and a split-half reliability and test-retest reliability of 0.878 and 0.960, respectively. This indicates that the Chinese version of the NTIS has good internal consistency and time stability. The scale-level content validity index (S-CVI) was 0.957, which indicated that the Chinese version of NTIS had good content validity. The total variance contribution rate was 79.055%, and three common factors were identified via exploratory factor analysis. The examined three-factor structure was confirmed by confirmatory factor analysis, which confirmed that all fit indices were appropriate. Conclusions: The Chinese version of the NTIS was appropriate in terms of reliability and validity. This scale can be used to evaluate nurses' turnover intention, and the outcomes can aid nurse management in designing training initiatives and implementing preventive measures to decrease nurse turnover. [ABSTRACT FROM AUTHOR]

Background: Nutrient content and degree of processing are complementary but distinct concepts, and a growing body of evidence shows that ultra-processed foods (UPFs) can have detrimental health effects independently from nutrient content. 10 + countries currently mandate front-of-package labels (FOPL) to inform consumers when products are high in added sugars, saturated fat, and/or sodium. Public health advocates have been calling for the addition of ultra-processed warning labels to these FOPLs, but the extent to which consumers would understand and be influenced by such labels remains unknown. We examined whether the addition of ultra-processed warning labels to existing nutrient warning labels could influence consumers' product perceptions and purchase intentions. Methods: In 2023, a sample of adults in Brazil (n = 1,004) answered an open-ended question about the meaning of the term "ultra-processed," followed by an online experiment where they saw four ultra-processed products carrying warning labels. Participants were randomly assigned to view either only nutrient warning labels or nutrient plus ultra-processed warning labels. Participants then answered questions about their intentions to purchase the products, product perceptions, and perceived label effectiveness. Results: Most participants (69%) exhibited a moderate understanding of the term "ultra-processed" prior to the experiment. The addition of an ultra-processed warning label led to a higher share of participants who correctly identified the products as UPFs compared to nutrient warning labels alone (Cohen's d = 0.16, p = 0.02). However, the addition of the ultra-processed warning label did not significantly influence purchase intentions, product healthfulness perceptions, or perceived label effectiveness compared to nutrient warning labels alone (all p > 0.05). In exploratory analyses, demographic characteristics and prior understanding of the concept of UPF did not moderate the effect of ultra-processed warning labels. Conclusions: Ultra-processed warning labels may help consumers better identify UPFs, although they do not seem to influence behavioral intentions and product perceptions beyond the influence already exerted by nutrient warning labels. Future research should examine how ultra-processed warning labels would work for products that do and do not require nutrient warnings, as well as examine the benefits of labeling approaches that signal the health effects of UPFs. Trial registration: ClinicalTrials.gov, NCT05842460. Prospectively registered March 15th, 2023. [ABSTRACT FROM AUTHOR]

Introduction: Scholars have become increasingly interested in incorporating robots into healthcare. While there is a growing body of research examining nurses' and patients' attitudes towards using robots in healthcare, no prior research has specifically explored their willingness to integrate service robots within the Egyptian healthcare context. Aim: The aim of this study was twofold: (a) to explore the behavioral intentions of nurses to accept robots in their workplace, and (b) to examine the willingness of patients to use service robots in healthcare settings. Methods: A mixed-methods study was conducted. Quantitative data were collected from 301 nurses using the Behavioral Intention to Accept Robots in the Workplace Scale and from 467 patients using the Service Robot Integration Willingness Scale through convenience sampling at three tertiary public hospitals in Port Said, Egypt. Qualitative data were obtained through in-depth, semi-structured interviews with 16 nurses, focusing on their perspectives and concerns regarding robot integration. Descriptive analyses were used to analyze quantitative data, and thematic analysis was used to analyze qualitative data. Results: Quantitative results indicated a moderate level of behavioral intention to use robots among nurses. Patients demonstrated low willingness to use service robots. In the qualitative analysis of the data obtained from the interviews with nurses, three categories (Concerns about Robots, Roles and Competencies, and Potential Benefits) and eight themes (interaction and emotions, maintenance and reliability, job insecurity, role clarity, competence in critical care, trustworthiness, reducing physical strain, and specialized applications) were identified. Conclusion: The results of this study indicate that nurses' behavioral intention to accept service robots in healthcare settings is moderate and their acceptance is influenced by various factors related to their concerns about robots, roles and competencies, and potential benefits they could gain. Patients showed a low level of willingness to use service robots in healthcare settings. Implication: Providing targeted educational programs to nurses and patients, assuring them with the provision of robust maintenance protocols, enhancing their confidence in the capabilities of robots, and defining clear roles for robots are crucial for the successful integration of robots into healthcare settings. [ABSTRACT FROM AUTHOR]

Aim: We aimed to examine the relationships among nurses' career compromise, job satisfaction, and turnover intention and the mediating role of job satisfaction in the relationship between career compromise and turnover intention. Background: Nurses are prone to career compromise when there is a discrepancy between the reality of their job and their personal career expectations due to personal or family factors. High levels of career compromise may have a significant impact on turnover intentions through low job satisfaction, thereby affecting the stability of the nursing workforce. There is a paucity of research on the impact of nurses' career compromise on turnover intentions. Method: This was a cross-sectional research design of nurses in hospitals in Guangdong Province using a convenience sampling method. The Career Compromise Scale (CCS), Job Satisfaction Scale (JSS), and Turnover Intention Scale (TIS) were used. The obtained data were analyzed through descriptive statistics, Spearman's correlation coefficient, and the mediating effect of perceived organizational support was tested through the PROCESS macro mediation model in SPSS. Results: Data from 821 nurses who met the inclusion criteria were analyzed. The total score of nurses' turnover intention was 14.68 ± 4.32. Spearman's correlation analysis showed that career compromise was negatively correlated with job satisfaction (r = -0.594, p < 0.01), job satisfaction was negatively correlated with turnover intention (r = -0.471, p < 0.01), and career compromise was positively correlated with turnover intention (r = 0.544, p < 0.01). The mediating effect of job satisfaction on the relationship between career compromise and turnover intention has been demonstrated. The mediating effect is significant, with a value of 0.056, representing 25.71% of the total effect. Conclusions: The turnover intention of nurses in Guangdong Province is high. Job satisfaction mediated the relationship between career compromise and turnover intention. This study further enriches JD-R theory and COR theory and provides new perspectives for nurse managers to develop intervention strategies to stabilize the nursing workforce and reduce turnover. [ABSTRACT FROM AUTHOR]

Background: Missed nursing care refers to any aspect of care performed by nursing staff that is omitted or significantly delayed. Even though the potential impact of missing nursing care on maternal and fetal outcomes is significant, there is currently limited evidence regarding the extent of this issue specifically within the maternity wards. Therefore, this study aimed to assess missed nursing care and associated factors in the maternity wards of public hospitals in the Sidama region, Ethiopia 2022. Methods: A hospital-based cross-sectional study was conducted among 361 nurses and midwives in maternity wards of Sidama region public hospitals from March 28 to April 26, 2022. Simple random sampling was used to select participants. The data was collected using the MISSCARE survey tool and analyzed with SPSS version 26. Simple linear and multiple linear regression analyses were used to identify the factors associated with missed nursing care. Results: The overall mean missed nursing care score was 67 out of 130 (95% CI: 65.92, 68.02) and the average score for each nursing intervention was 2.58 out of 5 (95% CI: 2.54, 2.62). The intention to leave the institution (β = 3.812, 95% CI: 2.285, 5.340) and increasing weekly work hours (β = 0.203, 95% CI: 0.134, 0.272) were factors positively associated with missed nursing care. However, increased work experience (β= -0.963, 95%CI: -1.475, -0.452) and job satisfaction (β= -4.976, 95%CI: -6.431, -3.522) were negatively associated with missed nursing care. Conclusion: This study found that the level of missed nursing care was significant. Factors positively associated with missed nursing care included an intention to leave the institution and an increase in weekly work hours. In contrast, an increase in work experience and higher job satisfaction were negatively associated with missed nursing care. [ABSTRACT FROM AUTHOR]

Background: Psychological support programs can help nurses who involved in patient safety incidents. However, most of these programs are operated internally by healthcare providers and utilize peer supporters, which may take a long time to implement. Therefore, there is a need to develop programs that can be used by healthcare providers in healthcare institutions that have difficulty implementing their own programs. This feasibility study aimed to develop an external support program for nurses as second victims and to examine the feasibility, acceptability, and impact of the program. Methods: This study was conducted using a single-group pretest-posttest design. Nurses who experienced patient safety incidents were recruited through posters at three advanced general hospitals, as well as open online recruitment and via a research agency panel from September 2020 to April 2021. The 11 participants attended a total of three one-on-one counseling sessions. Feasibility was evaluated based on participant recruitment and retention, resource availability, program procedures, and the practicability of data collection. Acceptability was assessed through program satisfaction and participant feedback. Psychological impact was measured using the Impact of Event Scale-Revised Korean version. Results: Out of 26 applicants, 11 (42.3%) completed the program, with 10 (38.5%) participants completing both pre and post-program surveys. Most participants responded that they were satisfied with the program and expressed their intention to recommend the program to others and participate in it again if similar situations arise. The participants' median total IES-R-K score decreased significantly from 30.0 to 16.0 (p = 0.028, r = 0.67). Conclusion: This study demonstrates the feasibility of an external second victim support program and provides preliminary data suggesting its potential to alleviate the psychological impact of participants. To overcome the limitations of this study, it is necessary to conduct additional controlled trials with a longer follow-up period and a larger sample size. [ABSTRACT FROM AUTHOR]

Background: In China, Internet-Based Sharing Nursing Service (IBSNS) is a new mode of nursing service delivery that has been in practice for over five years, which enables nurses to provide care at clients' home. However, the acceptance and associated factors of IBSNS among caregivers of elderly with chronic diseases who are the major clients of the service were unclear. Aim: To explore the acceptance of IBSNS and its associated factors among Chinese caregivers of elderly patient with chronic diseases based on the modified Technology Acceptance Model (mTAM). Methods: A cross-sectional study was conducted from February 2023 to March 2023. Caregivers of hospitalized elderly with chronic diseases were recruited using convenience sampling method from three hospitals in Beijing, China. Data were obtained from self-reports of participants. Structural equation modeling was used to analyze data. Results: A total of 65.1% of the caregivers had neutral to weakly positive behavioral intention of IBSNS use. The mTAM model was supported with good model fit. Perceived ease of use was positively associated with perceived usefulness. Both perceived usefulness and perceived security were positively associated with attitude, consequently, attitude was associated with behavioral intention. Conclusions: Improving the ease of use, security, and usefulness may be helpful to increase the positive attitude towards IBSNS and behavioral intention of using IBSNS, which provides valuable insights that can help healthcare providers improve the integration of technology in patient care, ultimately leading to better health outcomes and more efficient healthcare systems. [ABSTRACT FROM AUTHOR]

Background: In recent years, there has been a significant decrease in the desire to have children among Chinese women of childbearing age, particularly for the first child. This trend has sparked a growing interest in understanding the underlying factors. Although perceived stress has been speculated as an important factor in decreasing fertility intention, the precise mechanism is unclear. The current study, therefore, aims to investigate the psychological mechanisms linking perceived stress to fertility intentions among women of childbearing age without children, a topic of significant relevance and importance. Methods: Data were sourced from Chinese residents' psychology and behavior investigation (PBICR-2022). A multistage random sampling method was applied to recruit eligible participants. The Mplus8.3 software constructed a chain path model among the variables. Results: The median fertility intention was 30(3–60) on a scale of 0 to 100. The mediation analysis revealed a significant negative influence of perceived stress on fertility intention (β = − 0.076, P < 0.001). Additionally, a more intricate pattern of chain-mediating effect was observed involving perceived stress, anxiety (β = 0.037, P < 0.05), family communication (β = 0.106, P < 0.001), subjective well-being (β = 0.088, P < 0.001) and fertility intention. Conclusions: Perceived stress not only directly suppressed fertility intention but also indirectly affected it through anxiety, family communication, and subjective well-being. Effective family communication and favorable subjective well-being emerged as factors that could augment fertility intentions among women of childbearing age without children. [ABSTRACT FROM AUTHOR]

Background: Retaining midwives and registered nurses in the Obstetrics and Gynecology department/unit (OB/GYN) is not just a matter of organizational effectiveness and financial wellness. It's a crucial aspect of ensuring quality healthcare delivery. This study aimed to discuss the degree to which midwives and nurses in OB/GYN departments are structurally empowered, resilient, and committed to remaining at the organizations and to examine whether nurses' and midwives'sense of structural empowerment and resilience is a good predictor of their decision to stay with the organization. Methods: This study employed a unique convergent parallel mixed methods approach. The research was conducted in two distinct phases. The first phase involved a cross-sectional quantitative survey with a convenience sample of 200 midwives and nurses in OB/GYN departments. The second phase was a qualitative study utilizing semi-structured, open-ended interviews. Eighteen nurses and midwives, specifically chosen as the target population, were invited to participate in individual interviews. The data collection took place at three major hospitals in Saudi Arabia, starting in January 2023 and concluding in February 2023. Results: The study results revealed that structural empowerment and resilience were statistically significant predictors of the intent to stay in the organization (F = 35.216, p < 0.001), with 26.3% variation, the structural empowerment is higher predictor (β = 0.486, p < 0.000) to intent to stay if compared to resilience (β = 0.215, p < 0.008). Five major themes emerged from the narratives of the nurses and midwives: the nurturing of the physical and physiological, the development of the psychological, the managing finances, the restructuring of the organization, and the enrichment of the professional and occupational. Conclusion: The study's findings have significant implications for healthcare organizations. They highlight the importance of cultivating a culture of empowerment and resilience, which can serve as a powerful tool to encourage registered nurses and midwives to remain in their organizations. This insight empowers healthcare administrators, human resource managers, and obstetrics and gynecology professionals to take proactive steps toward improving retention rates. [ABSTRACT FROM AUTHOR]

Background: Globally, there is increasingly high prevalence of mental disorders across all age groups and social classes with more being projected by 2030, but without commensurate resources for mental health care delivery especially in developing countries. Purpose: This study examined the impacts of clinical psychiatric posting on career choice in psychiatry among nursing students in Ebonyi state, Nigeria. Methods: A prospective cohort research design was used and data were collected using attitude towards psychiatry (ATP), mental illness clinician attitude scale (MICA-4) and researcher developed questionnaires on career choice in pre and post clinical posting approach. This study was conducted between November, 2023 to May 2024. A sample size of 400 students (with data collected before posting and after posting) were involved in the study. Data were coded, cleaned and analyzed using SPSS version 26. McNemar Test was used to determine effects of clinical posting on career choices in psychiatry. Simple and multiple logistic regressions were used to analyze data on determinants of career choices in psychiatry. The hypotheses (Null and alternative hypotheses) were tested at p-value < 0.05. Results: Psychiatric and mental health nursing was one of the least preferred specialty, 21(6%) respondents showed interest before clinical posting and 25(7.1%) after the posting. Commonly preferred specialty was pediatric nursing (20.5%), community health nursing (17.1%) and midwifery (17.7%). McNemer test showed no statistically significant differences in choice of psychiatry before and after clinical posting. Key determinants of career choices were interest in psychiatry (AOR = 16.06(95% CI = 1.10, 14.96) P = 0.009), interest in community services (AOR = 4.01(95% CI = 1.32, 12.20)P = 0.014), family influence(AOR = 13.76(95% CI = 1.74, 108.57)p = 0.013) and job satisfaction(AOR = 0.10(95% CI = 0.03, 0.26)P < 0.001). Conclusion: The researcher therefore concluded that clinical psychiatric posting has no significant impacts on career choices in psychiatry among nursing students in Nigeria. Interest of the students, family influence and job satisfaction were significantly associated with career choices among the respondents. [ABSTRACT FROM AUTHOR]

Background: Human papillomavirus (HPV) infection significantly contributes to the global cancer burden. Understanding the factors influencing male clinical interns' willingness to promote HPV vaccination is crucial for developing effective public health strategies in China. Methods: This study employed a stratified random sampling method to select 1,980 male clinical interns from five provinces in China between January and March 2024. Data were collected on participants' demographic characteristics, HPV-related clinical experience, and knowledge. The Theory of Planned Behavior framework, encompassing attitudes, subjective norms, and perceived behavioral control, was used to examine factors influencing the willingness to promote the HPV vaccine. Logistic regression analyses were conducted to identify factors associated with the willingness to promote the HPV vaccine. Results: Among the respondents, 72.29% were willing to encourage others to receive the HPV vaccine. Significant factors influencing this willingness included older age (OR = 3.065, P ≤ 0.001), higher monthly household income (OR = 1.449, P = 0.025), participation in the diagnosis and treatment of HPV-related diseases (OR = 3.458, P ≤ 0.001), positive attitude towards the vaccine (OR = 13.503, P = 0.004), and strong perceived behavioral control (OR = 2.364, P = 0.006). Conclusion: This study highlights the critical role of practical experience and targeted education in promoting HPV vaccination among male clinical interns in China. Enhancing the training and education of this group is essential for improving HPV vaccine advocacy and supporting public health efforts to reduce HPV-related diseases. [ABSTRACT FROM AUTHOR]

Background: A train-the-trainer approach can effectively support the integration of new practice standards for health and social services professionals. This study describes the effects of an enhanced train-the-trainer program to support registered nurses and social workers working in primary care clinics in their understanding of the fundamental principles of primary care. Methods: We implemented an enhanced train-the-trainer program for registered nurses and social workers in six primary care clinics. We conducted a pre-post study using quantitative and qualitative data to assess trainers' and trainees' intention, commitment, and confidence in applying acquired knowledge. Results: We trained 11 trainers and 33 trainees. All the trainers and trainees were satisfied with the program. Trainers were less confident in their abilities as trainers following the training, especially regarding tailored coaching (p = 0.03). Trainees' commitment to becoming familiar with the functioning of their clinic (p = 0.05) and becoming part of the team increased significantly (p = 0.01); however, their intention to use their knowledge decreased (p = 0.02). Trainers and trainees identified organizational and professional barriers that may explain the observed decrease. Conclusion: An enhanced train-the-trainer program positively impacted registered nurses' and social workers' assimilation of the fundamental principles of primary care. Further research is needed to understand the long-term effects of train-the-trainer programs on primary care trainees and how these effects translate into patient care. [ABSTRACT FROM AUTHOR]

Aims: To synthesise evidence regarding organisational practice environment factors affecting healthcare workforce development, recruitment, and retention in the UK. Methods/data sources: A systematic search of PubMed, Web of Science, EMBASE, and PsycINFO yielded ten relevant studies published between 2018 and 2023 and conducted in the UK (the last search was conducted in March 2023). Adhering to The Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines, two independent reviewers conducted screening, sifting, and data extraction, applying the quality assessment tool for risk of bias. Results: Results highlight key factors associated with staff intention to leave/turnover/retention: workplace challenges, aggression, moral distress, on-the-job embeddedness, leadership involvement, organisational support, and flexible shift patterns. Notably, aggression from colleagues, including clinical staff but not interdisciplinary personnel, has a more detrimental impact on staff intention to leave than aggression from patients. Conclusion: The complex and context-dependent impacts of these organisational factors on the UK healthcare workforce underscore the need for tailored interventions. The review acknowledges limitations, including bias from excluding qualitative studies, a small pool of included studies, and nurse overrepresentation. Summary statement: What is already known: Securement and retainment issues affect different aspects of health and care services. Moreover, healthcare workforce shortages persist in the UK. What this paper adds: Our findings on the importance of workplace challenges and aggression, moral distress, on-the-job-embeddedness, leadership, flexible shift pattern, and organisational support in staff retention are important to addressing the current UK healthcare workforce crisis. Implications for practice/policy: The findings of this review are important to healthcare commissioners, policymakers, and stakeholders, offering valuable insights for dealing with factors contributing to shortages in the healthcare workforce and enhancing staff satisfaction and retention. [ABSTRACT FROM AUTHOR]

Background: Nursing educators play a critical role in training future nurses, and high turnover can disrupt the training quality and process. This study identified the institutional and personal factors influencing Canadian nursing educators' job satisfaction and turnover intention. Methods: This cross-sectional study used an online survey to obtain the levels of job satisfaction, turnover intention, role description, and institutional and personal/demographic characteristics of nursing faculty across Canadian institutions. Data were analysed using descriptive statistics, chi-square, bivariate linear regression, and hierarchical linear regression. Results: A total of 645 participants, with a mean ± SD age of 48.82 ± 10.11 years, returned a completed questionnaire. The average/maximum job satisfaction and turnover intention scores were 12.59/20 ± 3.96 and 6.50/15 ± 3.05, respectively. Higher job satisfaction was significantly associated with lower turnover intention (β=-0.559, p < 0.001). The multivariate analysis showed that having a partner or being married (β = 0.086, p = 0.031), working ≤ 40 h weekly (β=-0.235, p < 0.001), teaching ≤ 4 courses annually (β=-0.115, p = 0.007), and having higher than bachelor's degree qualification (β=-0.091, p = 0.042) predicted high job satisfaction, while high turnover intention was associated with faculty in the Prairie region (β = 0.135, p = 0.006) and working ≥ 41 h weekly (β = 0.151, p = 0.001). Conclusion: Having a partner, manageable workload, and advanced qualifications positively influenced job satisfaction, while high turnover intention was associated with high workloads. Institutions may benefit from ensuring proportionate faculty workloads, fostering career advancement, and providing robust support systems that can stabilise the workforce and preserve the quality of nursing education. [ABSTRACT FROM AUTHOR]

Background: The World Health Organization has recommended a new method for HIV self-testing (HIVST) using oral fluid, intending to increase HIV testing rates, and linking individuals to medical care. Healthcare workers are chief health advocates in the community who need adequate knowledge and intention to use the newly recommended HIVST approach. However, studies on awareness and the intention to use oral fluid for HIV self-testing among Ethiopian healthcare workers are limited. Therefore, this study aimed to assess healthcare workers' knowledge of and intentions to use oral fluid for HIV self-testing in Hadiya Zone public hospitals in southern Ethiopia in 2022. Methods: We conducted a facility-based cross-sectional study among a sample of 352 healthcare workers from 1 to 30 June 2022. The data were entered into Epidata version 4.2 and exported to SPSS version 23 for analysis. We used a logistic regression model with a 95% confidence interval for the interpretation of adjusted odds ratios (AORs) with P < 0.05. Results: Of the total participants, 40.3% had good knowledge, and 63.1% intended to use oral fluid (HIVST). Approximately 92% of healthcare workers had not received training, and 48.3% had heard about HIVST. Only 12.3% knew about the availability of the kit in hospitals, and 19.9% had ever used HIVST. Being male (AOR = 2.28; 95% CI 1.33–3.95), receiving support for the implementation of HIVST (AOR = 2.07; 95% CI 1.21–3.56), hearing about HIVST (AOR = 5.05; 95% CI 2.89–8.81), having prior experience using HIVST (AOR = 2.94; 95% CI 1.71–5.05), having a spouse or partner (AOR = 2.78; 95% CI 1.14–6.82), and having multiple sexual partners (AOR = 2.76; 95% CI 1.13–6.78) were associated with good knowledge of oral HIVST. Being aged 25–29 years (AOR = 2.54; 95% CI 1.18, 5.41), perceiving the high cost of the HIVST kit (AOR = 0.37; 95% CI 0.16–0.84), and having poor knowledge (AOR = 1.91; 95% CI 1.13–3.23) were significantly associated with the intention to use the oral fluid for HIVST. Conclusion: This study highlights the need for technical updating training for healthcare workers to increase their knowledge of and intention to use oral fluid for HIVST. Promoting oral fluid HIVST through targeted education, supporting initiatives, and addressing cost concerns related to the testing kit may increase the uptake of oral fluid HIVST among healthcare workers. [ABSTRACT FROM AUTHOR]

Background: Preconception care is a highly effective, evidence-based intervention aimed at promoting the health of reproductive-age women and reducing adverse pregnancy-related outcomes. The Ethiopian Ministry of Health plans to integrate preconception care services into the country's existing healthcare system. However, women's preferences may be influenced by their values and customs. Therefore, this study used the theory of planned behavior to assess women's intention toward preconception care use and its predictors among reproductive-age women in Arba Minch town, southern Ethiopia. Methods: A community-based cross-sectional study was conducted in Arba Minch town from May 1 to 30, 2022. A simple random sampling technique was employed to select 415 study participants for data collection. Data were collected through a face-to-face interview using a pretested, structured questionnaire. Epi Data version 4.6 and SPSS version 26 were used for the entry and analysis of data, respectively. Multiple linear regression was performed to identify independent predictors of intention to use preconception care. The standardized β-coefficient was used as a measure of association. A P value of less than 0.05 was used to declare statistical significance. Results: This study had 415 participants, giving a response rate of 98.3%. The mean age of the participants was 28.4 (SD 5.18). The mean intention to use preconception care was 21.43 (SD 2.47). Direct perceived behavioral control (β = 0.263, p < 0.001), direct attitude (β = 0.201, p = 0.001), direct subjective norm (β = 0.158, p = 0.006), and age (β=-0.115, p = 0.023) were significant predictors of women's behavioral intention to use preconception care. Conclusion: The study identified perceived behavioral control as the strongest predictor, followed by attitude and subjective norms, influencing the intention to use preconception care. These findings underscore the importance of integrating these predictors into health intervention programs aimed at promoting the implementation of preconception care services. [ABSTRACT FROM AUTHOR]

Background: Oral problems are a common occurrence among school-age children. In order to develop effective oral health interventions and services, it is essential to determine children's oral health behaviours using an internationally accepted standardised instrument that is child-friendly. However, no instrument currently exists to measure oral health according to the Theory of Planned Behaviour (TPB) in Turkish school-aged children. The aim of this study was to investigate the psychometric properties of the Oral Health Questionnaire, which includes the components of the theory of planned behavior such as attitude toward children's oral health, subjective norm, perceived behavioral control, and self-efficacy, for the Turkish population. Methods: This was a methodological–descriptive–correlational study conducted on 298 school children aged 9–10 years. Data were collected using The Oral Health Questionnaire. The data were evaluated using explanatory and confirmatory factor analysis, Cronbach's alpha, item-total score correlation, and Pearson product-moment correlation analysis. Results: Factor analysis confirmed the five-dimensional structure. The factor loads were greater than 0.30, and all fit indices were greater than 0.90. The model consistency indexes were found to be X2 = 146.95, RMSEA = 0.053, GFI = 0.94, CFI = 0.98, IFI = 0.97, and NNFI = 0.97. The Cronbach's alpha values of its sub-dimensions were 0.71 and 0.80. Conclusions: The Turkish version of Oral Health Questionnaire is considered a reliable and valid instrument that can be used by professionals to determine children's attitudes, subjective norms, perceived behavioral control, and oral and dental health intentions toward tooth brushing. [ABSTRACT FROM AUTHOR]

Background: Within the Open Biological and Biomedical Ontology (OBO) Foundry, many ontologies represent the execution of a plan specification as a process in which a realizable entity that concretizes the plan specification, a "realizable concretization" (RC), is realized. This representation, which we call the "RC-account", provides a straightforward way to relate a plan specification to the entity that bears the realizable concretization and the process that realizes the realizable concretization. However, the adequacy of the RC-account has not been evaluated in the scientific literature. In this manuscript, we provide this evaluation and, thereby, give ontology developers sound reasons to use or not use the RC-account pattern. Results: Analysis of the RC-account reveals that it is not adequate for representing failed plans. If the realizable concretization is flawed in some way, it is unclear what (if any) relation holds between the realizable entity and the plan specification. If the execution (i.e., realization) of the realizable concretization fails to carry out the actions given in the plan specification, it is unclear under the RC-account how to directly relate the failed execution to the entity carrying out the instructions given in the plan specification. These issues are exacerbated in the presence of changing plans. Conclusions: We propose two solutions for representing failed plans. The first uses the Common Core Ontologies 'prescribed by' relation to connect a plan specification to the entity or process that utilizes the plan specification as a guide. The second, more complex, solution incorporates the process of creating a plan (in the sense of an intention to execute a plan specification) into the representation of executing plan specifications. We hypothesize that the first solution (i.e., use of 'prescribed by') is adequate for most situations. However, more research is needed to test this hypothesis as well as explore the other solutions presented in this manuscript. [ABSTRACT FROM AUTHOR]

Background: Nursing managers have the potential to significantly impact the outcomes of nurses, patients, and organizations. Their competencies for effective performance are crucial. The global nursing workforce is facing a severe shortage of nurses. Dissatisfaction with management is one of the most important reasons for nurses' inclination to leave their jobs. Therefore, this study examines the relationship between nursing managers' competencies, job satisfaction and intention to leave among clinical nurses. Methods: An analytical cross-sectional study was conducted on 354 nurses in five hospitals affiliated with Ardabil University of Medical Sciences from May to August 2023. This research used web-based software to design demographic information forms, nurse manager competency scale, turnover intention, and single-item job satisfaction questionnaires. The significance level for the study was set at p < 0.05. Results: This study revealed that participants had an average score of 3.06 out of 5 in perceived nurse manager competence. Only one-fourth of the participants (25.7%) were satisfied with their current job, and less than half (46.9%) intended to leave. Employee support and development, change and resource management, supervision and quality monitoring, and personal mastery positively influenced nurses' job satisfaction. These competencies hurt employees' intention to leave their jobs. Conclusions: The research findings indicate that nursing managers in Iran have lower competency than in previous studies. Developing and strengthening these competencies is very important, as it significantly improves job satisfaction and reduces nurses' tendency to leave their jobs. Additionally, the results show that nursing managers who excel in supporting and developing staff, resource management, quality supervision, and personal mastery positively impact nurses' job satisfaction. However, these competencies can also help reduce employees' intention to leave their jobs. Retaining and maintaining nurses in the healthcare field is of utmost importance. [ABSTRACT FROM AUTHOR]

Background: Rates of non-communicable diseases are disproportionately high among Native Hawaiian (NH) people, and the proportion of NH infants being fed human milk (HM) is the lowest among all ethnicities within the state of Hawaiʻi. The aim of this study was to explore biological, socio-economic, and psychosocial determinants of the initiation and duration of human milk feeding (HMF) among a study of NH mothers and infants. Methods: A sample of 85 NH mother-infant dyads who were participating in a larger prospective study were involved in this research. Recruitment for the parent was delayed due to the COVID-19 pandemic. Recruitment started in November 2020 and continued until April 2022. Questionnaires were distributed at birth, two-months, four-months, and six-months postpartum. Questionnaires addressed topics relating to maternal and infant characteristics and infant feeding practices. Descriptive statistics, comparative analysis, and multivariate logistic regression tests were conducted. Results: The majority of participating mothers were aged between 31 and 35 years, had some college education or more, were employed, and multiparous. The majority of infants were receiving HM at each timepoint (94% at birth, 78% at two-months postpartum, and 76% at four and six-months postpartum). Factors found to be significantly associated with HMF initiation and duration were prenatal intention to HMF, maternal educational attainment, Special Supplemental Nutrition Program for Women, Infants, and Children (WIC) participation, and Supplemental Nutrition Assistance Program (SNAP) recipiency. A prenatal intention to HMF was found to be a strong predictor of HMF at birth (aOR = 64.18, 95% CI 2.94, 1400.28) and at two-months postpartum (aOR = 231.55, 95% CI 2.18, 2418.3). Participants not involved with WIC were more likely to be HMF at four-months postpartum (aOR = 6.83, 95% CI 1.01, 46.23). Conclusion: This research supports existing evidence that prenatal intention to HMF and higher maternal educational attainment are positive predictors of HMF. WIC participation and being a SNAP recipient were found to be negatively associated with HMF which suggests a need for more culturally tailored support. Further research is required to reduce the gap in knowledge related to the determinants of HMF in NH. [ABSTRACT FROM AUTHOR]

Background: The turnover of newly graduated nurses is a severe challenge for healthcare systems, and so it is essential to identify its predictive factors. This study investigates whether professional commitment, career adaptability, career self-efficacy, anxiety, and depression levels before and after internship can predict the turnover intention of newly graduated nurses after one year of employment. Methods: In a longitudinal study, 271 undergraduate nursing students recruited by convenience sampling were surveyed before internship (T1), after internship (T2), and after one year of employment (T3), with all surveys conducted on the Wenjuanxing survey platform (www.wjx.cn). Generalized linear models and restricted cubic spline models were used to explore possible linear and nonlinear relationships between turnover intention and the variables of interest. Results: Professional commitment both pre-internship (β = −0.060, p = 0.007, 95% CI [− 0.104, − 0.016]) and post-internship (β = −0.053, p = 0.015, 95% CI [− 0.096, − 0.010]) can negatively predict turnover intention. There is also a negative linear relationship between post-internship career self-efficacy and turnover intention (β = −0.308, p < 0.001, 95% CI [− 0.436, − 0.180]). In addition, professional commitment both pre-internship (adjusted R2 = 0.046, p = 0.004) and post-internship (adjusted R2 = 0.068, p < 0.001), career self-efficacy both pre-internship (adjusted R2 = 0.039, p = 0.008) and post-internship (adjusted R2 = 0.116, p < 0.001), career adaptability both pre-internship (adjusted R2 = 0.057, p < 0.001) and post-internship (adjusted R2 = 0.039, p = 0.008), anxiety both pre-internship (adjusted R2 = 0.035, p = 0.014) and post-internship (adjusted R2 = 0.048, p = 0.003), and depression levels both pre-internship (adjusted R2 = 0.031, P nonlinear = 0.021) and post-internship (adjusted R2 = 0.053, p = 0.002) are nonlinearly associated with turnover intention. Conclusions: Nursing educators and clinical care administrators must take action to enhance the professional commitment and career self-efficacy of nursing students during their internship. It is also important to pay attention to their career adaptability, as well as to any anxiety or depression that they may experience during clinical practice. This can help to reduce the turnover intention during the first year of their nursing career. [ABSTRACT FROM AUTHOR]

Background: Previous studies have shown that shared decision-making (SDM) between a practitioner and a patient strengthens the ideal of treatment adherence. This study employed a multi-method approach to SDM in healthcare to reinforce the theoretical and methodological grounds of this argument. As the study design, self-reported survey items and experimental vignettes were combined in one electronic questionnaire. This technique aimed to analyze the effects of previous experiences and the current preferences regarding SDM on the intentions to follow-through with the medical recommendations. Method: Using quantitative data collected from the members of the Finnish Pensioners' Federation (N = 1610), this study focused on the important and growing population of older adults as healthcare consumers. Illustrated vignettes were used in the evaluation of expected adherence to both vaccination and the treatment of an illness, depending on the decision-making style varying among the repeated scenarios. In a within-subjects study design, each study subject acted as their own control. Results: The findings demonstrated that SDM correlates with expected adherence to a treatment and vaccination. Both the retrospective experiences and prospective aspirations of SDM in clinical encounters supported the patients' expected adherence to vaccination and treatment while decreasing the probability of pseudo-compliance. The association between SDM and expected adherence was not affected by the perceived health of the respondents. However, the associations among the expected adherence and decision-making styles were found to differ between the treatment and vaccination scenarios. Conclusions: SDM enables expected treatment adherence among older adults. Thus, the multi-method study emphasizes the importance of SDM in various healthcare encounters. The findings further imply that SDM research benefits from questionnaires combining self-report methods and experimental study designs. Further cross-validation studies using various types of written and illustrated scenarios are encouraged. [ABSTRACT FROM AUTHOR]

Background: Early childhood educators play a critical role in promoting physical activity and reducing sedentary time in childcare centres. However, early childhood educators receive limited specialised pre- and in-service learning opportunities relating to these behaviours and may lack the capacity to effectively engage children in healthy movement behaviours. This study aimed to examine the efficacy of an e-Learning course on increasing early childhood educators' physical activity and sedentary behaviour-related capacities. Methods: A two-group parallel randomized controlled trial was conducted with early childhood educators in Canada (Mage = 41.78, 97% female). Participants randomized to the intervention group were asked to complete a physical activity and sedentary behaviour e-Learning course within a 4-week period. Participants randomized to the waitlist control condition were assigned to a waitlist to receive the intervention after the testing period. Participants reported on their self-efficacy, knowledge, intentions, and perceived behavioural control relating to physical activity and sedentary behaviours at baseline, post-intervention, and 3 months follow-up. Linear mixed effects models were estimated to determine difference in changes in outcomes from baseline to post-intervention, and follow-up. Results: A total of 209 early childhood educators participated in the study (intervention n = 98; control n = 111). The TEACH e-Learning course was found to be efficacious at improving all of the examined outcomes, with standardized effect sizes ranging from d = 0.58 to d = 0.65 for self-efficacy outcomes, d = 0.66 to d = 1.20 for knowledge outcomes, d = 0.50 to d = 0.65 for intention outcomes, and d = 0.33 to d = 0.69 for perceived behavioural control outcomes post-intervention. The intervention effects were sustained at follow-up for all outcomes apart from perceived behavioural control to limit screen time. Additionally, the magnitude of the effect for knowledge outcomes decreased at follow-up, with standardized effect sizes ranging from d = 0.49 to d = 0.67. Conclusions: The e-Learning course was highly successful at improving early childhood educators' capacity pertaining to physical activity and sedentary behaviours. Providing training content through e-Learning may be an efficacious approach to providing continual professional learning opportunities relating to physical activity and sedentary time to early childhood educators on a large scale. [ABSTRACT FROM AUTHOR]

Background: Mobile phone-based messaging for maternal education has shown promising outcomes in promoting maternal and child healthcare in low- and middle-income countries, where there is poor utilization of healthcare services. However, the success of a mobile phone messaging-based intervention depends on identifying and addressing the underlying factors that determine its utilization before implementation. Objective: To assess pregnant mothers' intention to use a mobile phone-based messaging intervention to improve maternal and newborn health in Jimma Zone, Ethiopia. Method: This study employed a cross-sectional study design among randomly selected pregnant mothers residing in six primary health care units that were selected from three districts of Jimma Zone, Ethiopia. Data were collected using an interviewer-administered structured questionnaire. Descriptive statistics such as frequencies, percentages, mean, and standard deviation were calculated and presented using tables. Multivariable linear regression analysis was used to identify predictors of intention. Standardized regression coefficients were used to understand the effect of the independent variables and outcome variable. A 95% confidence interval and a p-value of < 0.05 were considered significant. Result: Two hundred seventy-nine pregnant mothers participated in this study, resulting in a 98.9% response rate. Almost all (98.9%) respondents preferred the Afan Oromo language, 41.9% of respondents preferred the afternoon and 48.4% preferred receiving health information as text messages once daily. Having family members who can share SMS information (β = 0.098, 95% CI: (0.279—1.867), perceived usefulness (β = 0.283, 95% CI: (0.143—0.341), perceived easiness (β = 0.209, 95% CI: (0.054—0.392), perceived acceptability (β = 0.158, 95% CI: (0.007—0.178) and perceived feasibility (β = 0.186, 95% CI: (0.057—0.284) were found to have a positive significant association with the intention to use mobile phone-based messaging for maternal and newborn health. Conclusion: The majority of respondents preferred receiving mobile phone-based messaging on MNH in the Afan Oromo language, during the afternoon, and once daily. Having family members who share text message information, perceived usefulness, perceived easiness, perceived acceptability, and feasibility were significantly associated with intention. These findings highlight the importance of considering user preferences and determinants of intention when designing mobile phone-based messaging. [ABSTRACT FROM AUTHOR]

Background: Mental health problems, such as depression, have a high prevalence in young people. However, the majority of youths suffering from depression do not seek professional help. This study aimed to compare help-seeking behavior, intentions and perceived barriers between youthswith different levels of depressive symptoms. Methods: This cross-sectional study is part of a large-scale, multi-center project. Participants were n = 9509 youths who were recruited in German schools and completed a baseline screening questionnaire. Based on their depressive symptoms, youths were allocated to the following three subgroups: (a) without depressive symptoms, (b) with subclinical symptoms, (c) with clinical symptoms (measured by PHQ-A). Quantitative analyses compared previous help-seeking behavior, help-seeking intentions and perceived barriers (Barriers questionnaire) between these subgroups. An additional exploratory qualitative content analysis examined text answers on other perceived barriers to help-seeking. Results: Participants were mostly female (n = 5575, 58.6%) and 12 to 24 years old (M = 15.09, SD 2.37). Participants with different levels of depressive symptoms differed significantly in help-seeking behavior, intentions and perceived barriers. Specifically, participants with clinical depressive symptoms reported more previous help-seeking, but lower intentions to seek help compared to participants without symptoms (all p < 0.05). Participants with subclinical depressive symptoms reported a similar frequency of previous help-seeking, but higher intentions to seek help compared to participants without symptoms (all p < 0.05). Perception of barriers was different across subgroups: participants with clinical and subclinical depressive symptoms perceived the majority of barriers such as stigma, difficulties in accessibility, and family-related barriers as more relevant than participants without depressive symptoms. Across all subgroups, participants frequently mentioned intrapersonal reasons, a high need for autonomy, and a lack of mental health literacy as barriers to help-seeking. Conclusions: Youths with higher levels of depressive symptoms are more reluctant to seek professional help and perceive higher barriers. This underlines the need for effective and low-threshold interventions to tackle barriers, increase help-seeking, and lower depressive symptoms in adolescents and young adults differing in depression severity. Trial registration: DRKS00014685. [ABSTRACT FROM AUTHOR]

Aim: Assess the levels of psychological flexibility, burnout, and turnover intention among critical care nurses and assess the impact of psychological flexibility on burnout, and turnover intention among critical care nurses. Background: Burnout and turnover intentions among critical care nurses are rapidly increasing because of the challenges of COVID-19. There is a need for evidence-based interventions like psychological flexibility to be addressed in research to overcome those challenges. Methods: A descriptive correlational research. A convenient sample of 200 critical care nurses working in COVID-19 hospitals from two governorates in Egypt. The sociodemographic and clinical data sheet, the work-related acceptance and action questionnaire, the Copenhagen burnout inventory, and the adopted version of the staff nurses' intention to leave the nursing profession questionnaire were used. Results: The majority of critical care nurses reported a moderate level of psychological flexibility (75.5%, Mean = 31.23), a moderate level of burnout (65.5%, Mean = 59.61), and low to moderate levels of intention to leave (73%, Mean = 5.95). Psychological flexibility has a statistically significant negative correlation with burnout (PC = -0.304, Sig = 0.000) and the intention to leave (PC = -0.258, Sig = 0.000). In addition, psychological flexibility has a predictable effect on decreasing burnout (R2 = 0.232) and intention to leave (R2 = 0.127) among critical care nurses. Conclusion: critical care nurses in COVID-19 hospitals reported varied levels of burnout and an intention to leave that must be considered. The effect of psychological flexibility on burnout and intention to turnover highlighted the importance of improving it among critical care nurses by applying acceptance and commitment therapy as a management intervention. [ABSTRACT FROM AUTHOR]

Objective: Relational job characteristics include perceived social worth and perceived social influence. Good relational job characteristics mean that nurses have high prosocial behavior. The purpose of this study was to explore the potential profile of nurses' relational job characteristics, influencing factors and their differences in turnover intention and subjective well-being, thus finding the most suitable clinical relationship job characteristics. Methods: A cross-sectional survey was conducted among 1013 clinical nurses using the general demographic data questionnaire, Relational Job Characteristics scale, Turnover Intention Questionnaire and Campbell index of well-being. A latent profile analysis was performed to explore relational job characteristics latent profiles. Multinomial logistic regression analysis was conducted to examine the predictors of profile membership, and a one-way analysis of variance was applied to compare the turnover intention and subjective well-being in each latent profile. Results: Five latent profiles were identified and labeled 'High prosocial job characteristics' profile (20.7%), 'Moderate prosocial job characteristics' profile (41.7%), 'High social worth-low social impact perceived' profile (6.3%), 'Low social worth‐high social impact perceived' profile (18.8%) and 'Low prosocial job characteristics' profile (12.5%). Factors affecting the different types of nurse relationship job characteristics include age, marital status, hospital department, nursing years, professional title and hospital position. Among them, chief nurse, nurses with more than 20 years of nursing experience and obstetrics and gynecology nurses were more likely to be 'high prosocial job characteristics' profile. The turnover intention of nurses in 'high prosocial job characteristics' profile was significantly lower than that of other profiles, and their subjective well-being was significantly higher than that of other profiles. Conclusion: Improving nurses' perception of social worth and social impact on clinical work can improve nurses' prosocial behavior and subjective well-being, and reduce their turnover intention. Nursing managers or policy makers can formulate targeted intervention measures according to the influencing factors of potential profiles. [ABSTRACT FROM AUTHOR]

Background: There is a dearth of research examining the couple characteristics in determining contractive utilization behavior in developing countries. This study fills the gap by analyzing the roles of women's intra-household bargaining power and spousal age differentials in predicting contraceptive utilization behavior in Pakistani women. Methods: A sample of 13,331, excluding pregnant and sexually inactive married women aged 15–49, was extracted from the Pakistan Demographic and Health Survey 2017–18. The dataset is cross-sectional. Exploratory analysis was used to examine the pattern of contraceptive knowledge, types of contraceptive utilization, and intention to use contraceptives among women. Furthermore, binary regressions were employed to examine the association of women's intrahousehold bargaining power and spousal age difference with contraceptive utilization without and after accounting for all potential covariates. Results: Only 33% of women use contraceptives, while 30% express an intention to use contraceptives in the future. Almost all women (98%) knew about modern contraceptives. Compared to same-age couples, higher odds of current contraceptive use are observed among women whose husbands are at least 20 years older than them or whose husbands are young to them. The odds of the intention to use contraceptives tend to increase with the increase in spousal age difference. Women's intra-household bargaining is a significant predictor of current contraceptive utilization and intention to use contraceptives. Conclusion: Findings underscore the importance of considering the couple's characteristics in reproductive healthcare programming and policies. Recommendation: Greater women's intra-household bargaining power and smaller spousal age differences are associated with higher contraceptive usage. Empowering women and promoting their decision-making authority within households can enhance reproductive health outcomes. [ABSTRACT FROM AUTHOR]

This is a Matters Arising about an article titled "A structural equation modeling approach to investigate HIV testing willingness for men who have sex with men in China" in the issue of AIDS Res Ther 20, 64 (2023) " of this journal has been published. While thanking and appreciating the good authors of this article, we would like to explain some of the methodological issues of this study in order to clarify and disambiguate the methodology part of this article and other articles submitted in this style. First of all, it should be known that the concept and definition of structural equation modeling, the reason and method of doing it, specifying the observable and latent variables in the model, the exogenous and endogenous variables of the model, the correct way to draw the SEM graph, should be properly considered. The authors of this Matters Arising do not seek to refute or confirm the authors of this article. Our final opinion is that the methodology section should be written better and scientific clarification should be made in the methodology section for readers and interested parties. Purpose of the article: Clarifying the methodology for the mentioned article and other articles sent to this journal so that the readers and interested parties can better understand and apply the methodology content. [ABSTRACT FROM AUTHOR]

Background: Despite the challenge of nursing shortage in the world and its subsequent impact on care quality as well as aggravation of the situation by intention to leave service, this issue has not been properly addressed, especially among neonatal and pediatric nurses. The present study aims to identify the relationship between mental workload and musculoskeletal disorders with intention to leave the service among nurses working at neonatal and pediatric departments. Methods: This descriptive-analytical study was conducted on 145 nurses working at neonatal and pediatric departments in six hospitals in Bushehr Province using full-census method. The data were collected using national aeronautics and space administration-task load index (NASA-TLX), Cornell musculoskeletal discomfort questionnaire(CMDQ) and Mobley and Horner's voluntary turnover questionnaire. The data were analyzed using descriptive statistics, independent t-test, Mann-Whitney U test, one-way analysis of variance (ANOVA), Kruskal-Wallis test, Pearson's and Spearman correlation tests and hierarchical linear regression in simultaneous model in SPSS 19.0. Results: The mean score of intention to leave the service was 9.57 ± 3.20 (higher than the moderate level) and the mean mental workload was 71.65 ± 15.14 (high level). Pain in at least one of the legs (100%), back (77.3%) and knees (76.6%) was highly prevalent. However, no statistically significant correlation was found between musculoskeletal disorder categories and intention to leave the service (p > 0.05). The regression analysis results revealed among mental workload domains, only effort-induced workload was negatively and significantly correlated with intention to leave the service (p = 0.003; β=-0.078). However, the number of night shifts per month was positively and significantly correlated with intention to leave the service (p = 0.001; β = 0.176). Conclusions: Planning for appropriate allocation of night shifts, investigating the etiology of musculoskeletal disorders and providing solutions for reducing mental workload should be prioritized by policymakers, while maintaining pediatric nurses' motivation for making efforts. [ABSTRACT FROM AUTHOR]

Background: Medical error is a leading cause of disability and death in healthcare settings and reporting colleagues' medical errors is one of the main strategies for medical error management and an ethical responsibility of all healthcare providers, including nurses. Most studies into reporting colleagues' medical errors used quantitative designs while it seems that using qualitative designs can provide better insight in this area. Purpose: This study explored nurses' experiences of reporting the medical errors of their colleagues. Methods: This qualitative study was conducted using the conventional content analysis approach. Participants were 22 hospital nurses purposively selected in 2021–2022 from different cities in Iran. Twenty-two in-depth semi-structured interviews were held for data collection. The data were analyzed via Graneheim and Lundman's conventional content analysis and trustworthiness was maintained using the criteria proposed by Guba and Lincoln. Findings: The main categories of the study were burnout and intention to leave the profession and growth and development. The two subcategories of the first category were the experience of injury and the experience of violence and the two subcategories of the second category were sense of worthiness and sense of motivation. Moral distress was the most important experience of almost all participants. Conclusion: Nurses mostly have negative experiences in terms of reporting their colleagues' medical errors. Negative experiences can act as the barriers to report colleagues' errors while positive experiences can act as its facilitators. Improvement of the patient safety culture in healthcare settings and interpersonal relationships among healthcare providers can reduce the negative experiences and promote the positive experiences of reporting colleagues' medical errors. [ABSTRACT FROM AUTHOR]

Background: The theory of planned behavior is a conceptual framework of recent studies to identify and explain nurses' intentions to care for patients with emerging infectious diseases. However, correlations between behavioral intentions and variables that explain them have been inconsistent in previous studies. The influence of new variables might be considered in this case. This study aimed to determine moderating effects of ethical nursing competence on nurses' intention to care for COVID-19 patients in hospitals dedicated to infectious diseases based on the theory of planned behavior. Methods: A cross-sectional survey was conducted. Data on intention to care for COVID-19 patients, perceived behavioral control, attitude toward the behavior, subjective norm, and ethical nursing competence were obtained from 190 nurses in three hospitals dedicated to infectious diseases in South Korea. The moderating effect of ethical nursing competence was analyzed using model I of PROCESS Macro. Ethical considerations: This study was approved by the Institutional Review Board of Ulsan University Hospital, South Korea. Written informed consent was obtained from each subject. Results: The ethical nursing competence was a significant moderator in the relation between perceived behavioral control and the intention to care (B = 0.36, t = 2.16, p = 0.032). Ethical nursing competence did not have a significant interaction with attitude toward behavior or subjective norm. Conclusions: This study showed that the higher the ethical nursing competence level, the greater the effect of perceived behavioral control on nurses' intention to care for COVID-19 patients. Promoting ethical nursing competence is necessary for nurses who would take care of patients at the frontline of the infectious disease pandemic. Nursing managers should include ethical nursing competence in the assessment of nurses' competence and design educational programs to enhance ethical nursing competence for efficient nursing staffing during a pandemic. [ABSTRACT FROM AUTHOR]

Background: According to previous studies, stress and job burnout among medical personnel increased during the COVID-19 pandemic. This study analyzed the effect of the experience of COVID-19 response work on the intention of municipal hospital staffs to leave their workplaces during the pandemic. Methods: The 3556 employees who had worked for more than 1 year at one of the eight Seoul Municipal Hospitals that either provided inpatient treatment for quarantined COVID-19 patients or operated as screening clinics were taken as the study population. In total, 1227 employees completed a web or mobile survey between October 21 and November 18, 2020. A chi-squared test was performed to confirm the difference in the distribution of turnover intention depending on whether the employees performed COVID-19 response tasks. Multiple logistic regression analyses were performed to determine the factors that affected the intention to leave. Results: Of the 1227 respondents, 761 (62.0%) were frontline workers who were the first line of response to COVID-19. Experience with COVID-19 response tasks (OR = 1.59, p = 0.003) was significantly associated with the intention to leave. Additionally, the probability of turnover intention was significantly higher among workers aged 20–29 years (OR = 2.11, p = 0.038) and 40–49 years (OR = 1.57, p = 0.048), unmarried individuals (OR = 1.66, p = 0.005), doctors (OR = 2.41, p = 0.010), nurses (OR = 1.59, p = 0.036), and technical staff members (OR = 2.22, p = 0.009). High turnover intention was found among those who experienced high levels of burnout (OR = 2.03, p < 0.001) and those working in non-directly managed municipal hospitals (OR = 1.87, p = 0.018). Conclusion: Employees directly involved in COVID-19 response work displayed higher turnover intention. Various personal, job, and organizational factors significantly influenced employees' intentions to leave their positions in dedicated COVID-19 hospitals. These findings suggest the necessity of introducing management programs to aid workers who have experienced sudden changes in their duties and loss of autonomy while performing COVID-19 response tasks. [ABSTRACT FROM AUTHOR]

Background: The literature for assessing online and offline shopping behaviours that are linked to intelligent robotic goods and services is inadequate. In this study, we applied the Theory of Planned Behaviour model for guidance regarding how consumer behaviour affects their purchase intentions for intelligent robotic goods and services. Methods: Data from 408 respondents were gathered through an online questionnaire binned into Online and Overall Shoppers, and analysed using SPSS, AMOS, and Covariance-Based Structural Equation Modelling software to evaluate the appropriateness of the measurements and to confirm data reliability, convergence, divergence, and validity. These tools were also used to track and test hypothesized relationships between the variables and model constructs used in this study. Results and conclusions: The overarching outcomes from the data analyses indicated the Ease of Usage, Brand Perception, and Product Pricing variables causally impacted the TPB model constructs, namely Attitude, Subjective Norms, and Perceived Behaviour Control for the two populations tested with respect to their intention to purchase intelligent robotic goods and services. The reliability measurements for Ease of Usage, Brand Perception, and Product Pricing are discussed. The results are important for companies and future investors because opportunities to study the complex relationships that ultimately drive consumer behaviour and their intention to purchase intelligent robotic goods and services are provided. [ABSTRACT FROM AUTHOR]

Background: Although postgraduate studies have been shown to be associated with stressful experiences, students reading programmes through the distance and e-learning mode experience greater levels of stress due to several reasons. These stressful encounters might be heightened in female married postgraduates on distance education programmes due to other family-work-related engagements. This study investigated the stress-related experiences and intentions to quit studies among female married students on a distance education programme in Ghana. Methods: Using a sequential explanatory mixed-methods design, 164 married postgraduate distance education students were sampled to participate by responding to a questionnaire. Follow-up interviews were conducted with 10 participants to offer insight into the quantitative findings. Quantitative data were analysed using descriptive statistics, including frequency and percentages, while the qualitative data were thematically analysed. Results: Stress was prevalent among the female married distance education students, with the majority having intentions of quitting their studies. The stressors identified ranged from personal (i.e., work and family demands) to institutional ones (i.e., academic load, unresolved complaints and high financial demands from the programme). Conclusions: Key findings suggest that female married postgraduate distance education students perform multiple roles as full-time employees with family and academic demands that can negatively impact their health and academic work. Implications and recommendations of the findings are discussed. [ABSTRACT FROM AUTHOR]

Background: Culturally sensitive care is integral to effective and equitable healthcare delivery, necessitating an understanding and acknowledgment of patients' cultural needs, preferences, and expectations. This study investigates the perceptions of cultural sensitivity among general practitioners (GPs), focusing on their intentions, willingness and perceived responsibilities in providing care tailored to cultural needs. Methods: In-depth interviews were conducted with 21 Flemish GPs to explore their perspectives on culturally sensitive care. Data analysis followed a conventional qualitative content analysis approach within a constructivist framework. A coding scheme was developed to identify recurring themes and patterns in the GPs' responses. Results: Findings reveal that culturally sensitive care provision is perceived as a multifaceted process, initiated by an exploration phase where GPs inquire about patients' cultural needs and preferences. Two pivotal factors shaping culturally sensitive care emerged: patients' specific cultural expectations and GPs' perceived responsibilities. These factors guided the process of culturally sensitive care towards three distinct outcomes, ranging from complete adaptation to patients' cultural requirements driven by a high sense of responsibility, through negotiation and compromise, to a paternalistic approach where GPs expect patients to conform to GPs' values and expectations. Three typologies of GPs in providing culturally sensitive care were identified: genuinely culturally sensitive, surface-level culturally sensitive, and those perceiving diversity as a threat. Stereotyping and othering persist in healthcare, underscoring the importance of critical consciousness and cultural reflexivity in providing patient-centered and equitable care. Conclusions: This study emphasizes the significance of empathy and underscores the necessity for GPs to embrace the exploration and acknowledgement of patients' preferences and cultural needs as integral aspects of their professional role. It highlights the importance of shared decision-making, critical consciousness, cultural desire and empathy. Understanding these nuances is essential for enhancing culturally sensitive care and mitigating healthcare disparities. [ABSTRACT FROM AUTHOR]

Background: The scope of emergency medical services (EMS) has expanded from the urgent care of emergency patients to on-call healthcare services provided in the field with a holistic view of the patient's wellbeing. This challenges EMS to find solutions to cover all demands, while simultaneously setting high skill requirements for EMS personnel. Understanding personnel is a critical element in developing functional and resistant EMS. The aim of this study was to investigate how Finnish EMS personnel emphasize the Emergency Medical Services Role Identity Scale aspects of caregiving, thrill-seeking, duty, and capacity; and if these role identities are associated with intention to leave the profession. Methods: We conducted a cross-sectional survey (N = 616, 52% women, mean age 32.9 years). Data were collected through social media platforms and analyzed with means, standard deviations, Mann-Whitney U-tests, Kruskal-Wallis H-tests, and binary logistic regression analyses. Results: Our results indicate that capacity is the most emphasized aspect among EMS personnel, and at the same time, it increases intention to leave EMS. Capacity was followed by caregiving, with no association with intention to leave. Duty and thrill-seeking were the least emphasized and were negatively associated with intention to leave. Additionally, there were also other factors that were associated with emphasizing EMS-RIS aspect and intention to leave. Conclusion: Capacity stands out most strongly in analysis being at the core of the role identity of EMS personnel and was associated with a higher likelihood of leaving intentions. Several other factors were also associated with the intention to leave. Future studies should examine the exact dimensions of capacity that are considered important among EMS personnel and why factors such as work experience are associated with intentions to leave. [ABSTRACT FROM AUTHOR]

Background: The 24-h rooming-in policy is crucial to the Baby-Friendly Hospital Initiative (BFHI) for promoting breastfeeding. However, this policy may restrict maternal autonomy. In 2018, to integrate women's preferences into care decisions, Taiwan's Baby-Friendly certification included prenatal shared decision-making (SDM) for rooming-in. Prior to 2018, maternal knowledge, considerations, and intentions regarding rooming-in and the impact of prenatal SDM were unknown. Methods: A retrospective electronic medical record cohort study was conducted in southern Taiwan. Data on healthy postpartum women eligible for rooming-in and breastfeeding for the years 2017 and 2019, reflecting the periods before and after prenatal SDM was introduced, were gathered. Maternal and newborn characteristics, maternal knowledge, considerations, and prenatal intentions for postpartum rooming-in and breastfeeding during hospitalization were collected. Additionally, data on actual postpartum rooming-in practices during hospitalization and exclusive breastfeeding (EBF) practices from birth to hospital discharge, to 1 month, and to 2 months postpartum were collected. Descriptive and non-parametric statistics were applied to analyze the data. Results: A total of 621 women in 2017 and 311 women in 2019 were included. After prenatal SDM was introduced, the rooming-in rate during hospitalization fell from 42.2% in 2017 to 25.6% in 2019 (p < 0.001), and the EBF rate declined from 45.9% to 35.7% (p = 0.01). Additionally, the 1-month postpartum EBF rate decreased from 46.4% in 2017 (n = 571) to 44.3% in 2019 (n = 264), and the 2-month postpartum EBF rate dropped from 45.5% in 2017 (n = 591) to 40.2% (n = 308). According to the 2019 Patient Decision Aids responses (n = 236), women demonstrated limited understanding of rooming-in, with only 40.7% expressing an intention toward 24-h rooming-in. Women of older maternal age (p < 0.001), with a graduate degree (p = 0.02), full-time employment (p = 0.04), and concerns about rest disruption (p < 0.001), were more likely to prefer non-24-h rooming-in. Conclusions: Initiatives must promote prenatal SDM to enable healthcare providers to address misconceptions and tailor education, thereby increasing women's intention toward 24-h rooming-in and EBF. Future research should explore women's experiences and unmet needs at BFHI facilities to inform the construction of a baby- and mother-friendly environment. [ABSTRACT FROM AUTHOR]

Objectives: To investigate differences in students' career intentions between UK medical schools. Design: Cross-sectional, mixed-methods online survey. Setting: The primary study included all 44 UK medical schools, with this analysis comprising 42 medical schools. Participants: Ten thousand four hundred eighty-six UK medical students. Main outcome measures: Career intentions of medical students, focusing on differences between medical schools. Secondary outcomes included variation in medical students' satisfaction with a prospective career in the NHS, by medical school. Results: 2.89% of students intended to leave medicine altogether, with Cambridge Medical School having the highest proportion of such respondents. 32.35% of respondents planned to emigrate for practice, with Ulster medical students being the most likely. Of those intending to emigrate, the University of Central Lancashire saw the highest proportion stating no intentions to return. Cardiff Medical School had the greatest percentage of students intending to assume non-training clinical posts after completing FY2. 35.23% of participating medical students intended to leave the NHS within 2 years of graduating, with Brighton and Sussex holding the highest proportion of these respondents. Only 17.26% were satisfied with the prospect of working in the NHS, with considerable variation nationally; Barts and the London medical students had the highest rates of dissatisfaction. Conclusions: This study reveals variability in students' career sentiment across UK medical schools, emphasising the need for attention to factors influencing these trends. A concerning proportion of students intend to exit the NHS within 2 years of graduating, with substantial variation between institutions. Students' intentions may be shaped by various factors, including curriculum focus and recruitment practices. It is imperative to re-evaluate these aspects within medical schools, whilst considering the wider national context, to improve student perceptions towards an NHS career. Future research should target underlying causes for these disparities to facilitate improvements to career satisfaction and retention. [ABSTRACT FROM AUTHOR]

Background: Substance use disorder (SUD) presents a range of public health challenges and consequences. Despite the prevention potential of screening and brief intervention (SBI) in the primary care setting, implementation is low. The purpose of this study was to assess associations of primary care clinicians' knowledge of SBI and SUD treatment, subjective norms, and perceived behavioral control with intention to incorporate SBI and SUD treatment into regular clinical practice. Methods: This online survey was administered to primary care clinicians who practice in Texas between March 1, 2021, and February 5, 2023. Survey questions were mapped to factors in the Theory of Planned Behavior and included measures of knowledge, subjective norms, and perceived behavioral controls related to SBI and SUD treatment. Intention to engage in SBI and SUD treatment was assessed as the outcome. Results: Of 645 participants included in this study, 59.5% were physicians. Knowledge was low, with less than half correctly reporting what was considered a standard drink (39.6%) and only 20% knew the correct number of alcoholic beverages considered risky drinking in 21-year-old non-pregnant women. Subjective norms, such as having colleagues within their practice support addressing SUDs, and perceived behavioral control such as having SUD screening routinized within clinic workflows, were positively associated with intention to implement SBI and SUD treatment in primary care settings. Conclusions: Modifying knowledge gaps, subjective norms, and perceived behavioral control requires a multipronged interventional approach that blends accessible clinician training with systemic workplace enhancements and a collective shift in professional norms. [ABSTRACT FROM AUTHOR]

Background: There is a great need for training and education in the nursing curriculum to improve nurses' knowledge and skills to provide oral health care. Methods: A pilot study was conducted to evaluate the use of a virtual reality (VR)-based Oral Health Care Learning System to train geriatric oral health care among nursing students. Fifty undergraduate nursing students were randomly assigned to experimental (n = 25) and control (n = 25) groups. The experimental group received the VR-based simulation training on geriatric oral health care and the training was implemented twice at two weeks apart from March to November 2021. The control group did not receive the training intervention. Knowledge, attitude, and self-efficacy of geriatric oral health care as well as the intention to assist oral health care for older adults were assessed at the beginning, second, and fourth weeks. Generalized estimating equations were used to analyze the effectiveness of the VR-based simulation training. Results: After the first round of training, students in the experimental group had significantly greater improvements in knowledge and self-efficacy of geriatric oral health care than in the control group. After the second round of training, students in the experimental group had significantly greater improvements in knowledge, attitude, and self-efficacy of geriatric oral health care as well as the intention to assist oral health care for older adult than in the control group. Conclusions: The VR-based simulation training was effective to improve undergraduate nursing students' knowledge, attitudes and self-efficacy of geriatric oral health as well as the intention to assist oral health care for older adults. The VR-based simulation learning system is an effective tool to provide practice experiences to build confidence and skills and to bridge the gap of understudied geriatric oral health content in entry-level nursing curricula. Trial Registration: ClinicalTrials.gov (NCT05248542; registration date 21/02/2022). [ABSTRACT FROM AUTHOR]

Background: Nurses turnover intention, representing the extent to which nurses express a desire to leave their current positions, is a critical global public health challenge. This issue significantly affects the healthcare workforce, contributing to disruptions in healthcare delivery and organizational stability. In Ethiopia, a country facing its own unique set of healthcare challenges, understanding and mitigating nursing turnover are of paramount importance. Hence, the objectives of this systematic review and meta-analysis were to determine the pooled proportion ofturnover intention among nurses and to identify factors associated to it in Ethiopia. Methods: A comprehensive search carried out for studies with full document and written in English language through an electronic web-based search strategy from databases including PubMed, CINAHL, Cochrane Library, Embase, Google Scholar and Ethiopian University Repository online. Checklist from the Joanna Briggs Institute (JBI) was used to assess the studies' quality. STATA version 17 software was used for statistical analyses. Meta-analysis was done using a random-effects method. Heterogeneity between the primary studies was assessed by Cochran Q and I-square tests. Subgroup and sensitivity analyses were carried out to clarify the source of heterogeneity. Result: This systematic review and meta-analysis incorporated 8 articles, involving 3033 nurses in the analysis. The pooled proportion of turnover intention among nurses in Ethiopia was 53.35% (95% CI (41.64, 65.05%)), with significant heterogeneity between studies (I2 = 97.9, P = 0.001). Significant association of turnover intention among nurses was found with autonomous decision-making (OR: 0.28, CI: 0.14, 0.70) and promotion/development (OR: 0.67, C.I: 0.46, 0.89). Conclusion and recommendation: Our meta-analysis on turnover intention among Ethiopian nurses highlights a significant challenge, with a pooled proportion of 53.35%. Regional variations, such as the highest turnover in Addis Ababa and the lowest in Sidama, underscore the need for tailored interventions. The findings reveal a strong link between turnover intention and factors like autonomous decision-making and promotion/development. Recommendations for stakeholders and concerned bodies involve formulating targeted retention strategies, addressing regional variations, collaborating for nurse welfare advocacy, prioritizing career advancement, reviewing policies for nurse retention improvement. [ABSTRACT FROM AUTHOR]