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Nursing interruptions occur frequently and often have adverse outcomes, threatening patient safety. Emergency departments have a high incidence of nursing interruptions owing to the concentration of critically ill patients and frequent emergencies. Current research mainly focuses on large hospitals and uses observation and interview methods. Therefore, there is a need to develop tools for measuring emergency nursing interruptions. This study develops a survey questionnaire on emergency nursing interruptions. It tests its validity and reliability by building on the conceptual framework of emergency nursing interruption proposed in the literature. Specifically, we develop a test version of the emergency nursing interruption survey questionnaire using a Delphi expert inquiry and preinvestigation. We selected 1047 emergency nurses in 22 provinces and autonomous regions of China to participate in the survey by completing the questionnaire between June and July 2023 to evaluate the validity and reliability of the questionnaire. The final questionnaire comprised 26 items across 5 dimensions—sources, types, interrupted nursing activities, consequences of interrupted nursing activities, and management of nursing interruptions. The content validity indexes were 0.948 at scale level and 0.842–1.000 at item level. We used exploratory factor analysis (EFA) to extract five common factors with a cumulative variance contribution rate of 66.550%. The results of the confirmatory factor analysis (CFA) demonstrated a good model fit. Cronbach's α coefficient of the questionnaire was 0.912, split‐half reliability was 0.846, and the retest reliability calculated using the intraclass correlation coefficient was 0.915. To ensure the structural validity of the scales, EFA and CFA were conducted using two different datasets. Thus, the questionnaire showed good validity and reliability and can be used to evaluate how nurses understand emergency nursing interruptions. [ABSTRACT FROM AUTHOR]

Background: Nursing aims to rely on the best evidence, yet nurses frequently struggle with statistics, impeding the integration of research into practice. The misuse of statistical significance and p values is a pervasive issue, widely debated across disciplines but often overlooked in nursing. Objective: This study seeks to elucidate key arguments surrounding the misuse of p values, assess their relevance to nursing, and propose recommendations for improvement. Approach: Conducting a critical literature review on the interpretation and reporting of statistical significance and its practical implications among nurses, nursing students, and scholars. Results: The literature reveals widespread misunderstandings of probability concepts in classical statistics, leading to the misuse of p values. Some scholars propose abandoning p values altogether due to these challenges. Rather than dismissing p values, this article provides insights into their historical context and proper application. Recommendations are offered for accurately interpreting results and integrating supplementary metrics. Fostering statistical competencies already at the undergraduate level can enhance statistical literacy and alleviate statistics anxiety among nursing students, a prevalent issue. Early exposure to statistical methods in nursing education empowers nurses to actively engage in research. Additional recommendations include preregistering analysis plans to mitigate publication bias and exploring alternative approaches such as Bayesian methods. Conclusions: While p values serve as a valuable tool for preliminary assessment against randomness in nursing research, their widespread misunderstanding necessitates multiple measures for accurate interpretation and understanding of statistical significance. It is imperative for nurse educators and researchers to incorporate these recommendations into their practices. [ABSTRACT FROM AUTHOR]

Background and Purpose: The present study is aimed at evaluating the effects of the COVID‐19 pandemic on Iranian adolescents' participation in various domains of life. The electronic version of the Iranian Adolescent Participation Assessment Tool‐COVID‐19 (IAPAT‐C) was developed and validated for this purpose. Methods: This study was conducted in two phases. In the first phase, the electronic version of the IAPAT‐C was developed and validated through a methodological study involving five stages: content validity review, cognitive interviews, item analysis, structural validity assessment using confirmatory factor analysis, and reliability analysis. The tool was adapted from the previously validated IAPAT and revalidated for this study. In the second phase, the effects of COVID‐19 on adolescents' participation were evaluated using a longitudinal one group before and after comparative design. The study involved 654 adolescents aged 13–18, and the data were analyzed using SPSS19 and G ∗Power 3 software. Results: The IAPAT‐C evaluates the participation of Iranian adolescents in 54 daily life activities before and after the COVID‐19 pandemic. It utilizes a 5‐point Likert scale and was validated through an expert panel review for content validity. Additionally, cognitive interviews with six adolescents confirmed its comprehensibility, relevance, and comprehensiveness. Item analysis, based on data from 38 participants, demonstrated strong interitem correlations (0.6–0.94) and excellent internal consistency (Cronbach's alpha > 0.7). The tool's structural validity was supported by confirmatory factor analysis, which showed that the measurement model was a good fit. Convergent and discriminant validity of model constructs were also confirmed. Notably, COVID‐19 significantly impacted all aspects of adolescents' lives, except for work. Conclusion: The electronic version of the IAPAT‐C was valid and reliable. COVID‐19 significantly affected various aspects of Iranian adolescents' daily lives. Accordingly, it is necessary to provide appropriate interventions and policies for this sensitive class. [ABSTRACT FROM AUTHOR]

Objective: To explore the influence of demographic factors and flourishing on workplace distractions in a cross‐country analysis of Saudi Arabia and Jordan. Methods: This cross‐sectional comparative study was conducted in two government hospitals: one in eastern Saudi Arabia and the other in northern Jordan. Data were collected from the nurses using convenience sampling. The required sample size was determined using the G∗Power software, with a target of 242 nurses per country, resulting in 484 participants. Ultimately, the final sample consisted of 437 nurses: 222 from Saudi Arabia and 215 from Jordan. Two online instruments were used to collect data on the distractions and flourishing. Results: The study found that "using the Internet" and "using the phone" were the most time‐consuming distractions among nurses, while "watching TV" was the least time‐consuming. There were significant associations between demographics and distractions, with participants from Saudi Arabia having lower distraction scores than participants from Jordan. Younger participants were more distracted than older participants, whereas male participants were more distracted than female participants were. Smokers and individuals with less expertise exhibit higher levels of distraction. Furthermore, degree of education was associated with higher levels of distraction. Nurses in Saudi Arabia experience a much greater loss of productivity due to distractions than their Jordanian counterparts. Regression analysis revealed that experience, "Mental and Physical Health" domain scores, smoking status, and educational level all highly predicted distraction levels among Saudi Arabian and Jordanian nurses, accounting for approximately 9.6% of the differences in distraction. Conclusion: In this cross‐country study on workplace distractions among Saudi and Jordanian nurses, "using the Internet" and "using the phone" emerged as the most time‐consuming distractions. Younger age, male sex, smoking, and less experience are associated with higher distraction levels. Additionally, higher education levels were linked to increased distraction. Implementing employee flourishing activities can help reduce distractions and enhance productivity. This study offers valuable insights into improving nurses' performance and well‐being. [ABSTRACT FROM AUTHOR]

Objective. This research aimed to validate the Informal Supporter Readiness Inventory (ISRI) for evaluating the preparedness of informal supporters, in an Australian sample, to provide assistance in the context of intimate partner violence (IPV). Method. The ISRI's four distinct factors were each assessed with separate confirmatory factor analyses (CFA). Reliability was calculated using Cronbach's alpha values, and test‐retest reliability was evaluated using intraclass correlation coefficients. Additionally, the ISRI's validity was assessed through Pearson's correlations with both convergent and divergent measures. Results. The CFAs supported the four distinct factors of the ISRI: normative, individual, situational‐emotion, and situational‐assessment. The measure exhibited good‐to‐excellent internal consistency across these factors and good test‐retest reliability at four weeks. Convergent validity was supported by a strong positive correlation with the Intent to Help Friends Scale, while its weak association with the Generic Job Satisfaction Scale supported divergent validity. Discussion. The ISRI has emerged as a practical instrument with relevance to certain Australian sociocultural dynamics, offering utility in both research and clinical settings. The ISRI supports a network‐oriented approach to IPV survivor support, assisting the alliance between formal and informal support mechanisms. Future research should focus on broadening the ISRI's applicability by assessing its effectiveness across diverse Australian populations. [ABSTRACT FROM AUTHOR]

Introduction. Retirement resources are considered one of the key determinants of well‐being and coping with the challenging situations of retirement courses. Therefore, due to the lack of a valid questionnaire for research and practice at the national level as well as international comparisons, this study was conducted to translate the original retirement resources inventory into Persian and assess the validity and reliability of the Persian version. Materials and Methods. The research employed a cross‐sectional descriptive methodological approach, beginning with translating the questionnaire into Persian. Psychometric properties were evaluated through face, content, construct validity, and reliability tests. 335 participants were involved in assessing construct validity, while 30 participants contributed to the internal consistency test, and 20 took part in the test‐retest reliability test. Data analysis was performed using SPSS Version 26 and AMOS 24 software. Results. The exploratory factor analysis (EFA) revealed eight components with eigenvalues greater than 1, accounting for 46.68% of the variance, with no questions being removed. Confirmatory factor analysis (CFA) indicated that all items had a factor loading above 0.3, resulting in a final model with 35 items and eight factors, supported by fit indices (χ2/df = 1.95, TLI: 0.87, IFI = 0.88, RMSEA = 0.05, GFI: 0.85). Reliability measures showed Cronbach's alpha coefficients ranging from 0.71 to 0.83 and an intraclass correlation coefficient (ICC) of 0.93. Conclusion. The study concludes that the Persian version of the RRI, encompassing 35 items across eight dimensions, is a valid and reliable tool for the Iranian retiree population. This validated inventory can be utilized in future national and international studies, particularly experimental ones, to develop well‐being and retirement adjustment programs, thereby aiding in understanding and supporting Iranian retirees. [ABSTRACT FROM AUTHOR]

Background. Nursing professionals are pivotal in coordinating care and incorporating quality and safety strategies to enhance patient outcomes. Therefore, nursing education is paramount in preparing nurses to deliver safe care. Aim. In this study, we aimed to explore the self‐reported patient safety competence acquired by undergraduate nursing students in classroom and clinical settings and to compare their perceptions of how broader patient safety issues are addressed in their programmes. Methods. We conducted a cross‐sectional study in a public university in London, United Kingdom, and included Bachelor of Science nursing students from all fields of nursing and Nursing Associate students (n = 250, response rate 21.3%). Students completed the Health Professional Education Patient Safety Survey (H‐PEPSS). Paired t‐tests examined the differences in learning (classroom versus clinical setting). Analysis of variance was used to explore differences in self‐reported patient safety competencies across programmes and to compare students' perceptions of how broader patient safety issues are addressed in their curricula. Results. Mean domain scores indicate high confidence levels in patient safety competence for learning gained in both classroom and clinical settings for all students (>4.0/5.0). Results also indicate a consensus among students from various programmes that broader patient safety issues are adequately addressed in the curricula. Self‐reported confidence was highest in respondents enrolled in the Nursing Associate programme and students with prior experience in a clinical setting. Students were confident about their learnings of patient safety in their educational programmes. Conclusions. Greater patient safety competence indicates comprehension and familiarity with knowledge boundaries, which in turn acknowledges the limitations of autonomous practice. Our findings underscore the need for targeted educational interventions to enhance specific areas of patient safety competence and emphasise the shared responsibility of educators in fostering a culture of safety within healthcare. [ABSTRACT FROM AUTHOR]

Background. Severe challenges in recruiting and retaining healthcare workers exist on a global level and are especially noticeable in elderly care services. Previous studies have not assessed how the attractiveness of a job is related to wellbeing at work among licensed practical nurses (LPNs) even though these professionals are vital in providing care to the elderly. Objective. The purpose of this study is to define factors that affect LPNs' attractiveness of work and wellbeing at work. Design. A cross‐sectional survey study. Participants. A large‐scale nationwide sample of 10 848 licensed practical nurses (LPNs) working in Finland. Methods. An online survey for LPNs working in Finland was conducted. Criteria for a good workplace (CFGW), measuring the attractiveness of work and wellbeing at work, were utilized. Descriptive and comparative analyses were performed. Cronbach's alpha values were tested to assess internal consistency (α = 0.739–0.915). An ANOVA or t‐test result which indicated a statistically significant between‐group difference (which was in line with difference ≥0.1) was considered as both statistically significant and significant in practice. Results. The core group, LPNs' wellbeing at work (m = 4.36), is extremely important factor of attractiveness of work. Regarding the subgroups high quality of care (m = 4.61), reconciling of work and private life (m = 4.59) and well‐functioning practices (m = 4.55) were most important. Well‐functioning practices associated with several background variables, e.g., with working for full‐time (p ≤ 0.001, mean = 3.10) and age (p < 0.001). LPNs over 56 years old, especially, regard well‐functioning practices important (p = 3.17). LPNs' who were 56 years old or older (m = 3.12) and those who had work experience 1 year or less (m = 3.19) stated rewarding work most important. Conclusions. The core group, wellbeing, is an exceptionally important for the LPNs attractiveness of work. The LPNs' wellbeing at work is supported by the quality of care and reconciliation of work and private life. [ABSTRACT FROM AUTHOR]

Background. The increasing use of continuous glucose monitor (CGM) necessitates a review of variables that impact accuracy and interrupt use. Manufacturer recommendations include removing CGMs before diagnostic imaging, such as X‐ray and computed tomography (CT). Early removal and replacement of CGM components present financial, clinical, and psychosocial burdens to the wearer and interrupt optimal management of diabetes for pediatric patients who receive a total pancreatectomy with islet autotransplantation (TPIAT). The study's aim was to evaluate the effect of scatter dose exposure during X‐ray or CT if the CGM remained intact but outside the field of view (FoV). Materials and Methods. Participants were followed through the first 3 months after TPIAT surgery, managed diabetes with an insulin pump and CGM, and were routinely exposed to diagnostic imaging. Participants' CGMs were unshielded by a protective apron during any X‐ray or CT procedures for the duration of the study period, and the transmitter was collected after expiration or removal. Glucometer data was collected from hospital records and home glucometer downloads. Mixed models were used to analyze absolute differences between matched CGM and glucometer values, and Clarke error grid analyses (EGA) were performed. Scatter dose exposure was derived using anthropomorphic phantoms and calculated retrospectively. Results. A total of 14 patients (median 12.2 years, 64% female) received a median of five diagnostic imaging procedures with a median cumulative scatter dose of 559 µGy. The absolute difference between the CGM and glucometer values was not significantly associated with the cumulative scatter dose (p = 0.17) or time from TPIAT (p = 0.24) when analyzed in a mixed model. Regardless of scatter dose exposure, time from TPIAT, or glucometer, ≥98% of glucose values fell within zones A and B on EGA. Conclusion. Scatter dose exposure from diagnostic imaging did not affect the clinical accuracy of CGM values for the duration of transmitter use. Leaving CGM components in place when not in the FoV during diagnostic imaging successfully mitigated interruptions to use and undue burden or cost to participants. [ABSTRACT FROM AUTHOR]

Background. Despite the importance of studying factors contributing to nursing students' attitudes toward artificial intelligence, yet according to our knowledge, no study has addressed the relationship between personality traits and the attitude of nursing students toward artificial intelligence. Aim. This study aimed to unveil whether nursing students' personality traits are related to their attitude toward AI. Methods. This multicenter cross‐sectional study included 218 nursing students from three governmental universities across various regions of the Kingdom of Saudi Arabia. Data were gathered online, utilizing the Big Five Inventory, the General Attitudes toward Artificial Intelligence Scale, and a demographic questionnaire. Descriptive statistics, Pearson's correlation, and regression analysis were employed. The research complied with the STROBE checklist. Results. Findings indicated that nursing students with a high score in the openness trait displayed positive attitudes toward artificial intelligence. Conversely, those who scored high in neuroticism and agreeableness exhibited fewer positive attitudes toward artificial intelligence and more negative attitudes toward artificial intelligence. Additionally, nursing students who ranked high in conscientiousness showed a negative attitude toward artificial intelligence. Conclusion. Except for extraversion, personality traits appear to predict attitudes toward artificial intelligence. Implications for Nursing Management. The current study provides a foundation for understanding how generative AI can be integrated into nursing education and practice in a manner that is both effective and considerate of the diverse psychological profiles of students. [ABSTRACT FROM AUTHOR]

Background. Second victim experiences have long‐term impacts on the personal and professional well‐being of nurses. Individual‐centered support is necessary to help nurses cope with the various stages of the second victim experience. Objectives. To explore personal and workplace factors that facilitate or hinder coping styles for second victim experiences from the perspectives of both frontline nurses and nurse managers. Design. This was a descriptive qualitative study that incorporated semistructured interviews. Methods. Purposive sampling was employed to enlist a total of eight nurses and seven nurse managers selected from five tertiary hospitals located in Hunan Province, China. The study participants included nurses who had suffered second victim experiences and nurse managers who had grappled with their nurses' second victim experiences. The data were transcribed verbatim and analysed using thematic analysis. Results. The analysis revealed four main themes that influenced nurses' ability to cope with second victim experiences: source of emotional trauma, personal factors, job stress, and support system. In contrast, emotional trauma from patients and relatives, negative personal traits, shadows from the second victim experience, and unsupportive workplace environments were obstacles to coping with second victim experiences. Conclusion. The study highlights facilitators and barriers that nurses cope with second victim experiences, providing insight to develop targeted interventions that support nurses and mitigate the negative impacts of second victim experiences. A comprehensive approach is more effective in supporting nurses in coping with second victim experiences, improving patient safety, and enhancing the quality of care. [ABSTRACT FROM AUTHOR]

Background. Type 1 diabetes mellitus (T1DM) screening facilitates access to early intervention and prevention of severe complications, such as diabetic ketoacidosis. Despite its significance, many countries lack a systematic T1DM screening program. Understanding how the public perceives T1DM screening for children is essential for successfully implementing such programs but is currently an area with limited research. Our study aims to fill this gap by developing a standardized tool designed to assess the acceptability of T1DM screening programs for children, focusing on caregiver perspectives within the general population. Materials and Methods. We developed the Type 1 Diabetes Mellitus Screening Acceptability (DMSA) scale based on the theoretical framework of acceptability and integrated components from the Pediatric Testing Attitudes Scale‐Diabetes (P‐TAS‐D). It covers a broad spectrum of acceptability constructs. The DMSA scale underwent iterative modifications following expert feedback to refine clarity and content validity. We tested the scale in both Arabic and English with adults living in Saudi Arabia, regardless of their parental status, focusing on the potential of screening their children. The psychometric strengths of the scale were evaluated through reliability analyses and exploratory factor analysis. Results. Of the 599 participants, the majority were female (89.2%), with a mean age of 35.9 ± 8.6 years. The final DMSA scale consists of 10 items, with two distinct factors: "individual acceptability" and "psychosocial acceptability." The mean total score was 42.9 ± 5.1 across a potential range of 10–50 points. The English and Arabic versions of the scale demonstrated strong reliability, with Cronbach's alpha values of 0.84 and 0.79, respectively. Conclusions. The DMSA scale emerges as a valid and reliable tool for gauging the acceptability of the general population of screening children for T1DM. It integrates key elements of the acceptability construct, pivotal for guiding the implementation of culturally sensitive T1DM screening initiatives. Future research should expand its application across various cultural settings and examine the correlation between scale scores and actual screening behaviors. [ABSTRACT FROM AUTHOR]

Background. Sleep is a crucial factor affecting an individual's physical and mental health. Psychiatric nurses work under high stress and load, and it is necessary to understand the sleep quality of psychiatric nurses and the influencing factors. However, individual‐centred studies of psychiatric nurses' sleep are limited. Aims. To explore the heterogeneity in sleep quality among psychiatric nurses, to identify the factors influencing different subtypes, and to provide targeted strategies and measures to improve their sleep quality. Methods. From August to October 2022, 298 psychiatric nurses working in a mental health centre in Liaoning Province were selected as the participants. The study involved administering the following two questionnaires: the general information questionnaire and the Pittsburgh Sleep Quality Index (PSQI). Data analyses included latent profile analysis, Kruskal–Wallis H test, and multiple logistic regression. Results. The prevalence of poor sleep quality (PSQI >5) among psychiatric nurses was 54.7%. The sleep quality of psychiatric nurses could be classified into the following three distinct profiles: good sleep quality, moderate sleep quality, and poor sleep quality. Nurses who were over 40 years of age, unmarried/divorced/separated/widowed, worked more than 40 hours per week, experienced significant life events in the past year, had poor nurse‐patient relationships, and had chronic diseases were more likely to have poorer sleep quality. Conclusions. There was significant heterogeneity in sleep quality among psychiatric nurses. Age, marital status, work schedule, total weekly working hours, night shifts, special life events, nurse‐patient relationships, and chronic diseases were associated with their sleep quality. Implications. The heterogeneity and influencing factors of sleep quality in psychiatric nurses provided evidence for individualized interventions in the future. This trial is registered with ChiCTR2200062347. [ABSTRACT FROM AUTHOR]

Objective. Due to various long‐term consequences of the disease, cancer survivors (CS) can experience incompatibilities between areas of life (work, family, household, leisure time, and disease) that can be associated with reduced satisfaction with these areas of life. To be able to assess such incompatibilities quantitatively, a six‐item instrument (INCOMPAT‐CS) was developed and psychometrically evaluated. Methods. Based on relevant theories, a multidisciplinary team developed the items of the INCOMPAT‐CS. Descriptive analyses, exploratory and confirmatory factor analyses, as well as validity and reliability assessments were conducted using survey data from n = 293 CS collected as part of the CARES study. Incompatibilities between areas of life were measured with the newly developed INCOMPAT‐CS instrument. Results. A one component solution with satisfactory model fit (normed χ2 = 1.90, RMSEA = 0.06, CFI = 0.99, and TLI = 0.97) was identified in exploratory and confirmatory factor analyses. The INCOMPAT‐CS demonstrated acceptable internal consistency (Cronbach's α = 0.790) and high test‐retest reliability ρ = 0.569 (p < 0.001). Convergent validity could be demonstrated (CR = 0.858 and AVE = 0.506). Hypothesis‐consistent correlations with role and social functioning measures further indicate convergent validity. Conclusions. The INCOMPAT‐CS is useful to assess incompatibilities among areas of life in CS quantitatively. Moreover, it helps to reveal the areas negatively affected due to incompatibilities. This short instrument can be useful in aftercare or psychosocial support interventions to detect incompatibilities and work towards reducing them as a consequence to increase CS' wellbeing. [ABSTRACT FROM AUTHOR]

Objective. To assess repeatability and agreement of central vault for implantable collamer lens (ICL) measured by the Tomey OA‐2000 biometry and Spectralis optical coherence tomography (OCT). Methods. In this prospective study, the central vault was measured by the Tomey OA‐2000 biometer and Spectralis OCT in 84 eyes (43 patients) after ICL implantation at six month follow‐up. Three consecutive scans were obtained by one experienced technician using Tomey OA‐2000 and the Spectralis OCT in the same day. The coefficient of variation (CoV), intraclass correlation coefficient (ICC), within‐subject standard deviation (Sw), and 2.77 Sw were calculated to assess the repeatability and reproducibility. The paired t‐test and Bland–Altman plots were used to analyze the differences and agreements of central vault measured by two devices. Results. Repeatability of the central vault measured by Tomey OA‐2000 biometer and Spectralis OCT showed that the CoV was 2.71% and 1.66%, respectively. The ICC for both devices was 0.996 and 0.999, respectively. The paired t‐test showed that central vault measured by Tomey OA‐2000 biometer was −7.25 ± 23.57 microns lower than that measured by Spectralis OCT (P = 0.006). The mean difference between measurements for Tomey OA‐2000 and ASM‐OCT with 95% limits of agreement (LoAs) was −38.94 to 53.44 μm. Conclusion. Both Tomey OA‐2000 biometer and Spectralis OCT displayed good repeatability for the measurement of central vault of ICL. Good reliability and agreement were observed between Tomey OA‐2000 biometer and Spectralis OCT. Both instruments are useful but not replaced each other for central vault measurements. [ABSTRACT FROM AUTHOR]

Aim. To explore the status of job crafting, leisure crafting, and burnout among nurses and to examine the impact of job crafting and leisure crafting variations on burnout using machine learning‐based models. Background. The prevalence of burnout among nurses poses a severe risk to their job performance, quality of healthcare, and the cohesiveness of nurse teams. Numerous studies have explored factors influencing nurse burnout; however, few involved job crafting and leisure crafting synchronously and elucidated the effect differences of the two crafting behaviors on nurse burnout. Methods. Multicentre cross‐sectional survey study. Nurses (n = 1235) from four Chinese tertiary hospitals were included. The Maslach Burnout Inventory‐General Survey, the Job Crafting Scale, and the Leisure Crafting Scale were employed for data collection. Four machine learning algorithms (logistic regression model, support vector machine, random forest, and gradient boosting tree) were used to analyze the data. Results. Nurses experienced mild to moderate levels of burnout and moderate to high levels of job crafting and leisure crafting. The AUC (in full) for the four models was from 0.809 to 0.821, among which the gradient boosting tree performed best, with 0.821 AUC, 0.739 accuracy, 0.470 sensitivity, 0.919 specificity, and 0.161 Brier. All models showed that job crafting was the most important predictor for burnout, while leisure crafting was identified as the second important predictor for burnout in the random forest model and gradient boosting tree model. Conclusion. Even if nurses experienced mild to moderate burnout, nurse managers should develop efficient interventions to reduce nurse burnout. Job crafting and leisure crafting may be beneficial preventative strategies against burnout among nurses at present. Implications for Nursing Management. Job and leisure crafting were identified as effective methods to reduce nurse burnout. Nurse managers should provide more opportunities for nurses' job crafting and encourage nurses crafting at their leisure time. [ABSTRACT FROM AUTHOR]

Aim. The aim of this study was to understand the current status of knowledge-attitude-practice of ICU nurses in tertiary care hospitals regarding swallowing disorders after extubation of tracheally intubated patients and to analyse the influencing factors. Design. A cross-sectional study. Background. Most patients admitted to the ICU have an endotracheal tube, which may be the cause of acute and/or chronic problems after extubation. Therefore, training of ICU nurses and early extubation are essential to prevent these problems. Methods. A convenience sample of clinical nurses (n = 627) was selected from Grade A Hospitals in Northwest, North, and Central China as the study population. Survey instruments included the Questionnaire on ICU Nurses' Knowledge, Attitude, and Practice of Postextubation Swallowing Disorders in Patients with Tracheal Intubation. Data Sources. Data were sourced from structured questionnaire responses. Results. A total of 647 ICU nurses participated in this survey, with 627 valid questionnaires. The three dimensions of knowledge, attitude, practice, and the total score of the questionnaire on ICU nurses' knowledge, attitude, and practice of postextubation swallowing disorders in patients with tracheal intubation were (6.46±3.09), (7.53±1.69), (4.89±2.00), and (18.88±5.18), respectively. Multiple linear regression analysis showed that the factors affecting the total score of PED among ICU nurses were age, nationality, professional title, job satisfaction, and mode of employment. Gender, age, nationality, and job satisfaction were the factors that influenced the score of knowledge. The influencing factors of attitude score include gender, age, nationality, section, professional title, job satisfaction, and mode of employment. The influencing factors of the score of knowledge include professional title and job satisfaction. Conclusion. The current status of ICU nurses' knowledge-attitude-practice regarding postextubation dysphagia in tracheally intubated patients is generally at a moderate to low level, and the level of knowledge-attitude-practice needs to be further improved. Implications for Nursing Management. The results of the study showed that the knowledge, attitude, and practice of ICU nurses towards tracheal intubation patients' postextubation dysphagia were in the lower middle level. Therefore, it is necessary to improve the knowledge, attitude, and practice of ICU nurses towards tracheal intubation patients' postextubation dysphagia. This may include, but is not limited to, the development of tools for assessing PED, systematic and professional training, and the development of multidisciplinary collaborative models. [ABSTRACT FROM AUTHOR]

This paper extends our previous method for COVID-19 diagnosis, proposing an enhanced solution for detecting COVID-19 from computed tomography (CT) images using a lean transfer learning-based model. To decrease model misclassifications, two key steps of image processing were employed. Firstly, the uppermost and lowermost slices were removed, preserving sixty percent of each patient's slices. Secondly, all slices underwent manual cropping to emphasize the lung areas. Subsequently, resized CT scans (224 × 224) were input into an Xception transfer learning model with a modified output. Both Xception's architecture and pretrained weights were leveraged in the method. A big and rigorously annotated database of CT images was used to verify the method. The number of patients/subjects in the dataset is more than 5000, and the number and shape of the slices in each CT scan varies greatly. Verification was made both on the validation partition and on the test partition of unseen images. Results on the COV19-CT database showcased not only improvement from our previous solution and the baseline but also comparable performance to the highest-achieving methods on the same dataset. Further validation studies could explore the scalability and adaptability of the developed methodologies across diverse healthcare settings and patient populations. Additionally, investigating the integration of advanced image processing techniques, such as automated region of interest detection and segmentation algorithms, could enhance the efficiency and accuracy of COVID-19 diagnosis. [ABSTRACT FROM AUTHOR]

Purpose. Breast cancer is considered a huge health problem among women all over the world due to its increased mortality rate. Breast cancer deaths are decreased by 28–34% due to improvement in treatment and early detection. In order to detect breast cancer early and provide the best possible therapy, knowledge and awareness are essential. So, this study aimed to assess risk of breast cancer among nurses, the knowledge and practices of breast self-examination (BSE) and determine its barriers, and implement an educational program for them. Design. A quasiexperimental research design was used. Methods. This study was conducted at two university hospitals (main university hospital and woman's health hospital). A purposive sample of 280 nurses with age more than thirty-five years were included in the study using three tools, namely, structure interview questionnaire, breast cancer risk assessment tool, and a structured breast cancer knowledge and practice questionnaire. Nurses' knowledge and practices regarding breast cancer and BSE were first assessed and then they were provided with two educational courses covering theoretical and practical information. One month after the program ended, the nurses' knowledge and practices were assessed again. Results. About 3.2% of the participants have five years high risk of developing breast cancer according the risk assessment tool, the main barriers of do not do BSE did not find any symptoms and scared from finding any abnormality. There was a significant increase in knowledge and practice of breast self-examination posteducation compared to pre-education (73.2 and 98.2%, respectively). Also, there was a statistically significant difference between pre- and postprogram with a p value of 0.0001. Conclusion. This study concluded that 3.2% of the nurses with high risk of developing breast cancer needed a follow-up; more than half of them do not perform breast self-examination because they think that do not have any symptoms in the breast and the educational program with a significant effect on knowledge and practices of nurses. So, the researchers recommend the nurses need for an empowerment program and support by providing assistance in places of work as done free clinical examination and mammography by female specialist for privacy. [ABSTRACT FROM AUTHOR]

Context. Insulin sensitivity and secretion indices can be useful tools in understanding insulin homeostasis in children at risk for diabetes. There have been few studies examining the reproducibility of these measures in pediatrics. Objective. To determine whether fasting or oral glucose tolerance test (OGTT)-derived insulin measures would be more reproducible and whether there would be differences based on weight, sex, race, and pubertal status. Design. Observational study. Setting. Clinical research unit. Patients or Other Participants. Two hundred fifty-seven overweight/obese (BMI ≥ 85th%, n = 186) and normal weight (BMI < 85th%, n = 71) children without diabetes between ages of 8 and 17 were included in the study. Methods. OGTT tests performed in study participants at two separate visits within a 3-week period. We performed two formal oral glucose tolerance tests within a 3-week period. The reproducibility of fasting measures was compared with OGTT-derived measures by weight categories and compared by weight, sex, race, and pubertal status. Comparisons were made between the correlation coefficients of fasting vs. OGTT-derived measures and between normal weight vs. obese/overweight participants, male vs. female, White vs. Black, and pre- vs. post-midpubertal. Intraclass correlation coefficients were calculated for each comparison as well. Results. For insulin sensitivity, the OGTT-derived measure was more reproducible than the fasting measures. There were no significant differences in reproducibility in the overweight/obese population compared to the normal weight population nor by sex, race, or pubertal status. Conclusions. Nonfasting insulin sensitivity measures are more reproducible than fasting insulin sensitivity measures, regardless of weight category. Insulin secretion measures have poor reproducibility overall. Weight status, sex, race, and midpubertal stage do not impact the reproducibility of insulin sensitivity and secretion measures. [ABSTRACT FROM AUTHOR]

Globally, child labor and maltreatment are considered serious public health concerns. Many child laborers in the informal sector are subjected to psychological abuse and neglect that is often akin to slavery. Our study examined the prevalence of these two forms of maltreatment among child laborers in rural Bangladesh, as well as the associated risk factors. Based on the snowball sampling technique, this study surveyed 100 child laborers employed in agricultural and domestic work in rural areas of the Sunamganj district, Bangladesh. The structured questionnaire utilizes the ICAST-CH instrument. To analyze the data, both simple and multiple linear regression analyses were conducted using two statistical software packages, SPSS and STATA. The study concluded that more than half of the child laborers have experienced psychological maltreatment "sometimes" in the form of being screamed at and insulted over the past year. In the past year, over 40% of respondents indicated they were "sometimes" deprived of food and drink and were not well cared for when they became ill. Multivariate analysis demonstrated that parents of psychologically maltreated child laborers had low educational backgrounds. A higher risk of neglect was observed among child laborers who worked for extended hours for their employers and whose families possessed limited land. In spite of the high prevalence of psychological maltreatment and neglect of child laborers in Bangladesh, the issue appears to be ignored. More comprehensive and rigorous scientific studies are required to bring about policy change. [ABSTRACT FROM AUTHOR]

Background. As nursing interns enter challenging clinical settings, evaluating their preparation and readiness is vital for adaptation success. Sufficient real-world experience and patient care are crucial preparation components that enable effective practice and higher competencies. Aim. This study aimed to assess nurse interns' perception of clinical preparation and readiness for clinical internship experiences. Methods. A self-administered questionnaire was distributed, comprising three sections on demographics, clinical preparation requirements, and the Casey–Fink Readiness for Practice Survey. Descriptive statistics as the mean and standard deviation, numbers and percentages, linear regression model, and Pearson correlation coefficient were used for reporting normal distribution, categorical variables, and relationship between a scalar response and one or more explanatory variables and to calculate statistics between two continuous variables. Results. The participants were 130 nurse interns who were involved in an internship between 2016 and 2020, 50% of the nurse interns. They had a moderate level of clinical preparation, and 28.5% of them exhibited a low level. In addition, 53.8% were found to be moderately ready for practice, while 22.3% had a low level of readiness Conclusion. The observed significant positive correlation between perceived preparation and readiness underscores the pivotal role of clinical preparation in influencing practice readiness. Implications. These findings emphasize the importance of targeted interventions aimed at enhancing clinical preparation to directly bolster overall readiness for professional practice among nurse interns. [ABSTRACT FROM AUTHOR]

Background. Nurses' creativity is an imperative necessity for healthcare organizations to grow. The creative abilities of nurses are affected by many factors; some of these factors are stimulants and some of these are inhibitors. Supervisors' knowledge sharing behavior and the capacity to absorb new knowledge and technologies are important factors in the recent era that delineate the creativity of nurses. Aim of the Study. Assess the effect of supervisor knowledge sharing behavior and organizational absorptive capacity on nurses' creativity. Method. Cross-sectional multicenter descriptive correlational exploratory research design was used to conduct the study. Data were collected conveniently from 700 nurses recruited from five large hospitals at Alexandria, Egypt, using three self-administered printed questionnaires. Findings were investigated via descriptive and inferential statistics as well as structured equation modeling. Results. Nurses' creativity was positively associated with supervisor knowledge sharing behavior and organizational absorptive behavior (r = 0.619, p value <0.001, and r = 0.545, p value <0.001, respectively). Supervisor knowledge sharing behavior accounted for 87% of variance in nurses' creativity, while organizational absorptive capacity accounted for 55% of variance in nurses' creativity. Conclusion. Supervisors' knowledge sharing behavior and absorptive capacity of organization are powerful significant stimulants for nurses' creativity. Implications to Nursing Management. Hospital directors, managers, and nursing leaders should cultivate knowledge sharing behavior in healthcare settings by establishing a reward and incentive system for healthcare workers who share their knowledge with their colleagues for mutual benefit and organizational development. [ABSTRACT FROM AUTHOR]

Students' academic performance is substantially influenced by their learning approaches, which reflect their intentions when confronted with a learning situation and the corresponding strategies they employ to fulfil these intentions. Since there was no validated questionnaire that aimed to assess students' learning approaches in the context of Vietnam, the purpose of this study is to validate a Vietnamese short version of the approaches and study skills inventory for students (ASSIST). A cross-sectional study involved translation and validation with a group of Vietnamese undergraduate nursing students. This questionnaire was translated by two independent bilingual experts and reviewed by a team of two other experts. To test the internal reliability, Cronbach's alpha was used with 102 nursing students in a nursing school. Regarding construct validity, the study checked whether the original three subscales fit the data by using confirmatory factor analysis in a group of 1340 nursing students from ten nursing schools across Vietnam. The result indicated that the internal consistency of the Vietnamese ASSIST short version was good; Cronbach's alpha of the total scale was 0.89. Cronbach's alphas for deep, strategic, and surface approaches were 0.82, 0.89, and 0.70, respectively. By using confirmatory factor analysis, the model of three subscales showed a moderate fit (X2/df = 7.097, p < 0.01 , CFI = 0.927, TLI = 0.886, and RMSEA = 0.067). As such, this finding supported the proposed three-factor structure of the short version of ASSIST in the context of Vietnam, which will be a useful tool for educators and educational institutions to assess students' learning approaches initially. [ABSTRACT FROM AUTHOR]

Aim. To develop a scale for measuring nurse's perceived work environment during the public health emergencies (PHEs) and assess its reliability and validity. Background. Although there is extensive research on instruments for measuring nursing work environments in regular healthcare settings, there is a lack of specific scales tailored to address the unique work conditions experienced by nurses during PHEs. Design. This study employed a cross-sectional design for psychometric evaluation and adhered to the Strengthening the Reporting of Observational Studies in Epidemiology (STROBE) statement. Methods. A self-report scale, the Chinese Nursing Work Environment Scale for Public Health Emergencies (C-NWE-PHE), was developed, integrating situational characteristics. Data on demographics, adapted scale scores, and subjective evaluations of nursing management performance were collected from 1156 nurses through online surveys conducted between January 2023 and March 2023. Confirmatory factor analysis, Pearson correlations, and Cronbach's alpha analyses were conducted to evaluate the psychometric properties of the scale. Results. The adapted C-NWE-PHE scale comprised 28 items organized into five subscales: Workforce and Deployment Support, Leadership and Emergency Management, Autonomy and Empowerment, Teamwork and Collaboration, and Logistics and Humanistic Care. Structural equation modelling showed satisfactory factor loadings for each subscale and a good model fit, confirming construct validity. The content validity and reliability of the total scale were confirmed. Conclusion. This study provides empirical evidence for understanding and assessing the nursing work environment during PHEs with a psychometrically sound scale. Implications for Nursing Management. The C-NWE-PHE scale, along with its five identified constructs, provides a nuanced comprehension of working conditions amid PHEs. Implementing this scale could foster specific enhancements, support nurse retention efforts, and enhance the effectiveness of responses during challenging emergency situations. [ABSTRACT FROM AUTHOR]

Aims. To adapt the Authentic Nurse Leadership Questionnaire (ANLQ) to the Chinese cultural context and evaluate its psychometric properties. Background. Authenticity serves as a pivotal factor in the dynamic interaction between nurse leaders and nurse staff, exerting a profound influence on the growth of nurse individuals, healthcare teams, and organizations. However, there is still a dearth of research instruments to assess nurses' perception of authentic leadership in China. Methods. After authorization from the original author and technical support had been secured, a systematic process of initial translation, back translation, expert panel review, and pretesting was employed to ensure cross-cultural adaptation in accordance with established guidelines. A two-stage study design was implemented. In stage 1, 189 nurses were sampled for psychometric validation, during which the internal consistency reliability, split-half reliability, and test-retest reliability were tested and exploratory factor analysis was performed. In stage 2, 255 nurses were sampled for confirmatory factor analysis and assessment of convergent and discriminant validity, to further validate the constructs. Results. In stage 1, the validated instrument showed a Cronbach's alpha value of 0.973, a split-half coefficient of 0.888, and a test-retest reliability coefficient of 0.912. The exploratory factor analysis extracted five dimensions that accounted for 82.629% of the overall variance. The findings in stage 2 showed that the observed data were well fitted to the five-factor theoretical model, with acceptable levels of convergent and discriminant validity. Conclusions. The Chinese version of the ANLQ demonstrated appropriate psychometric properties, as evidenced by its good reliability and validity. Implications for Nursing Management. This study offers nurse administrators and executives a valuable instrument, enabling them to establish leadership evaluation criteria, conduct nurse leader performance appraisals, and assist in selecting new nurse leaders. Ultimately, this contributes to the cultivation and development of exceptional managers capable of providing positive leadership to their followers. [ABSTRACT FROM AUTHOR]

Aim. Midwives are prone to suboptimal health status (SHS), while there is a lack of unified measurement standard of SHS for them to early detect and prevent SHS. This study aimed to evaluate validity and reliability of Subhealth Measurement Scale V1.0 (SHMS V1.0) in midwives. Design and Methods. The cross-sectional study had 842 midwives from 46 midwifery institutions in southeastern China completing the SHMS V1.0 with 39 items. Internal consistency, test-retest reliability, and concurrent validity of SHMS V1.0 were assessed. Project analysis and confirmatory factor analysis (CFA) were performed to assess construct validity. Results. SHMS V1.0 had acceptable reliability with Cronbach's alpha and a test-retest reliability coefficient of 0.908 and 0.804, respectively. The correlation coefficients between each item and corresponding dimension and those between dimension and corresponding subscale were all greater than 0.4. The CFA supported the structure of SHMS V1.0 with strong factor loadings and excellent fit indexes in the first-order and modified second-order factor model, illustrating that SHMS V1.0 had good construct validity among midwives. The concurrent validity for SHMS V1.0 showed large correlation with FS-14, but the social subscale showed medium correlations with fatigue, inferring that SHMS V1.0 can more comprehensively reflect SHS of midwives than FS-14, especially for social health symptoms. Practice Implications. SHMS V1.0 with excellent psychometric properties can accurately and reliably evaluate the SHS of midwives. These findings of our study provide an important measurement tool and inspiration for midwives to early detect and prevent SHS. [ABSTRACT FROM AUTHOR]

Aims. This study aimed to explore workload whether Nursing Activities Scores on one shift could predict workload for the next shift. Method. This was a retrospective observational exploratory study of cross-sectional design carried out in a postoperative and intensive care unit at a local, nonprofit hospital in Norway. Data were collected from the hospital's internal database from January 1st to June 30th, 2016. Results. A total of 2,695 patients and 5,916 Nursing Activities Scores were included. The model could predict a 55.1% to 66.9% variation in Nursing Activities Scores for the next shift. When the number of patients was added, the model explained up to 80% of the variation. Conclusions. The Nursing Activities Score can be used to predict nursing workload from one shift to another and as an instrument for managers to adjust their staffing requirements. Implications for Nursing Management. Nursing Activities Score assessing nursing workload for all patients in a unit can support the resource planning with accuracy for nurse staffing. [ABSTRACT FROM AUTHOR]

Good resilience skills support effective and timely adjustment to demanding situations in the workplace. Existing tools are insufficient to develop and evaluate workplace interventions to improve employee's resilience skills. The aim of this study was to develop and validate a Resilience Skills Questionnaire (RSQ) using the key constructs of social cognitive theory—self-efficacy, self-regulation, and social support—as a theoretical framework. Following DeVellis' guidelines for scale development, first an expert panel of thirteen professors was recruited to support the item development stages and determine content validity. At this stage, the initial pool of 38 items was reduced to 25 items and CVR and CVI were calculated as 0.92 and 0.93, respectively, indicating good content validity. A second panel of ten health professionals confirmed face validity. An online survey comprised of the 25 developed items was then completed by 336 health professionals working in urban healthcare centers in Shiraz, Iran, in November 2021. The data were used to assess the psychometrics of the questionnaire according to its hypothesized three-dimensional structure. Confirmatory factor analysis yielded a final model of seventeen items in three dimensions, self-efficacy (six items), social support (six items), and self-regulation (five items), with good psychometric properties ( χ 2 / df = 2.44 (p < 0.001), RMSEA = 0.06 , GFI = 0.92 , AGFI = 0.90 , IFI = 0.93 , CFI = 0.93). All standardized factor loadings were significant (p < 0.001). Internal consistency, as measured by Cronbach's alpha, was very good: RSQ (0.90), self-efficacy (0.86), social support (0.83), and self-regulation (0.86). Based on these results, the RSQ can be used as a standard and valid measure to develop and evaluate the effect of educational intervention programs to improve resilience skills and reduce job stress. [ABSTRACT FROM AUTHOR]

Objective. This study examined the preliminary reliability and validity of the PedsQL™ Family Impact Module (PedsQL FIM) in families of children with Barth syndrome (BTHS). Method. A total of 72 parents with children or youth between the ages of 5 and 19 participated in this study. Thirty-three parents of children with BTHS and 39 parents of unaffected children completed the PedsQL FIM and a demographic information form. Internal consistency reliability and item-total correlations were calculated to test the reliability of the PedsQL FIM. Construct validity was examined using the known-groups method. We estimated the mean score differences of the PedsQL FIM between the two groups using three different models, including unadjusted, multivariate regression, and propensity score matching with inverse probability of treatment weighting (PS-IPTW) models. Results. The Cronbach's alpha coefficients were greater than 0.70 for all scales of the PedsQL FIM, except for the communication scale. The item-total correlations were significant for all scales with moderate to high correlations (p <.05). In construct validity, the mean scores of the PedsQL FIM between the two groups were significantly different (p <.05) for all scales and total score in the unadjusted and PS-IPTW models. However, in the multivariate regression model, the family relationships scale was not significant between the two groups. Conclusion. The PedsQL FIM demonstrated adequate measurement properties of preliminary reliability and validity in assessing the impact of children with BTHS on parental health-related quality of life (HRQoL) and family functioning. Further research needs to be conducted to examine the psychometric properties of the PedsQL FIM with a large sample of BTHS and with other pediatric rare diseases. [ABSTRACT FROM AUTHOR]

Background. Senior citizens are usually infected by multiple chronic conditions and other health problems. Health needs and demand for healthcare services increase with age. However, healthcare services and facilities and their utilization are limited, particularly in developing countries. Aims. To identify the utilization of health services among senior citizens and their contributing factors. Methods. A cross-sectional analytic study was conducted among 293 senior citizens of the Kushma municipality, Nepal, from June to December 2019. A structured questionnaire was used as a data collection tool using a multistage sampling technique. Face-to-face interviews were conducted to collect data on the interview schedule. Reliability and validity were maintained by applying different strategies and carefully developing tools, pretesting, double entry, and validation. Data entry, management, and analysis were performed using Epi Data and SPSS software. Research ethics were maintained. Descriptive and inferential statistical tests were performed to infer the findings. Results. Study participants had a mean age (±SD) of 70.08 (±7.6) years and had various preexisting chronic diseases such as hypertension (46%), gastritis (41.9%), arthritis (34.3%), and asthma (28.7%). Only eight out of ten senior citizens had used health services in the past year. Factors such as age, ethnicity, residency, household income, family support, the presence of chronic diseases, and being under medication were found to have statistically significant associations with the utilization of health services among senior citizens with a p value less than 0.05 and 95% confidence interval. Conclusions. A remarkable proportion of older people reported using health services in the last year. However, a substantial proportion did not utilize health services that require further interventions to enable them. Efforts are required to promote the health and well-being of Nepal's growing elderly population, including potential enhancements to rural healthcare infrastructure by policymakers. [ABSTRACT FROM AUTHOR]

Background. Coronavirus disease (COVID-19) is an infectious illness that spreads widely over a short period of time and finally causes a pandemic. Unfortunately, the lack of radiologists, improper COVID-19 diagnosing procedures, and insufficient medical supplies have all played roles in these devastating losses of life. Deep learning (DL) could be used to detect and classify COVID-19 for potential image-based diagnosis. Materials and Methods. This paper proposes an improved deep convolutional neural network (IDConv-Net) to detect and classify COVID-19 using X-ray and computed tomography (CT) images. Before the training phase, preprocessing methods such as filtering, data normalization, classification variable encoding, and data augmentation were used in conjunction with the proposed IDConv-Net to increase the effectiveness of the detection and classification processes. To extract essential features, deep CNN is then employed. As a result, the suggested model can identify patterns and relationships crucial to the image classification task, resulting in more precise and useful diagnoses. Python and Keras (with TensorFlow as a backend) were used to carry out the experiment. Results. The proposed IDConv-Net was tested using chest X-rays and CT images collected from hospitals in Sao Paulo, Brazil, and online databases. After evaluating the model, the proposed IDConv-Net achieved an accuracy of 99.53% and 98.41% in training and testing for CT images and 97.49% and 96.99% in training and testing for X-ray images, respectively. Further, the area under the curve (AUC) value is 0.954 and 0.996 for X-ray and CT images, respectively, indicating the excellent performance of the proposed model. Conclusion. The findings of our proposed IDConv-Net model confirm that the model outperformed compared to existing COVID-19 detection and classification models. The IDConv-Net outperforms current state-of-the-art models by 2.25% for X-rays and 2.81% for CT images. Additionally, the IDConv-Net training approach is significantly quicker than the current transfer learning models. [ABSTRACT FROM AUTHOR]

Diabetic macular edema (DME) and age-related macular degeneration (AMD) are two common eye diseases. They are often undiagnosed or diagnosed late. This can result in permanent and irreversible vision loss. Therefore, early detection and treatment of these diseases can prevent vision loss, save money, and provide a better quality of life for individuals. Optical coherence tomography (OCT) imaging is widely applied to identify eye diseases, including DME and AMD. In this work, we developed automatic deep learning-based methods to detect these pathologies using SD-OCT scans. The convolutional neural network (CNN) from scratch we developed gave the best classification score with an accuracy higher than 99% on Duke dataset of OCT images. [ABSTRACT FROM AUTHOR]

Accurate evaluation of the critical nodes in the system is essential work for a multiplatform avionics system (MPAS) for resource allocation and other works. However, current evaluation methods are either limited to the aircraft level or the function module level. There is a lack of research on the evaluation using the information of these two levels. In view of this situation, this paper researches the two-level iterative method of evaluating the importance of aircraft function modules. The influence matrix was constructed by using the node access probability calculated by the PageRank algorithm and the function module weight calculated based on centrality. In addition, the importance of aircraft nodes was used to carry out two-level iteration, and finally, the importance of aircraft function modules was obtained. The experimental results show that this method can comprehensively utilize the information on aircraft cooperative network and function module cooperative network, solve the key problems of two-level iterative evaluation, and meet the requirement of evaluating critical nodes in a system. [ABSTRACT FROM AUTHOR]

The Bethesda System for Reporting Thyroid Cytopathology (TBSRTC) is a standardized system which is used to classify results of thyroid fine-needle aspiration (FNA). This system is used to evaluate and determine which patients should get thyroid surgery. It was created in order to reduce the number of patients requiring surgery. The question remains as to whether this reporting system is accurate in determining those nodules that have malignant potential and those that do not. This study is a retrospective analysis of patients in one institution who have undergone FNA and then thyroid surgery based on TBSRTC. The outcome of the pathology reports after surgery was analyzed to determine the accuracy of TBSRTC in our institution (Lourdes Hospital, Binghamton, NY). The results from our institution were compared with similar studies in other institutions to determine accuracy and reproducibility. Our results indicated that the risk of malignancy in each Bethesda category was similar to the risk percentages described for most categories in the 2017 TBSRTC update. [ABSTRACT FROM AUTHOR]

Background. The 3D T1W turbo field echo sequence is a standard imaging method for acquiring high-contrast images of the brain. However, the contrast-to-noise ratio (CNR) can be affected by the turbo factor, which could affect the delineation and segmentation of various structures in the brain and may consequently lead to misdiagnosis. This study is aimed at evaluating the effect of the turbo factor on image quality and volumetric measurement reproducibility in brain magnetic resonance imaging (MRI). Methods. Brain images of five healthy volunteers with no history of neurological diseases were acquired on a 1.5 T MRI scanner with varying turbo factors of 50, 100, 150, 200, and 225. The images were processed and analyzed with FreeSurfer. The influence of the TFE factor on image quality and reproducibility of brain volume measurements was investigated. Image quality metrics assessed included the signal-to-noise ratio (SNR) of white matter (WM), CNR between gray matter/white matter (GM/WM) and gray matter/cerebrospinal fluid (GM/CSF), and Euler number (EN). Moreover, structural brain volume measurements of WM, GM, and CSF were conducted. Results. Turbo factor 200 produced the best SNR (median = 17.01) and GM/WM CNR (median = 2.29), but turbo factor 100 offered the most reproducible SNR (IQR = 2.72) and GM/WM CNR (IQR = 0.14). Turbo factor 50 had the worst and the least reproducible SNR, whereas turbo factor 225 had the worst and the least reproducible GM/WM CNR. Turbo factor 200 again had the best GM/CSF CNR but offered the least reproducible GM/CSF CNR. Turbo factor 225 had the best performance on EN (-21), while turbo factor 200 was next to the most reproducible turbo factor on EN (11). The results showed that turbo factor 200 had the least data acquisition time, in addition to superior performance on SNR, GM/WM CNR, GM/CSF CNR, and good reproducibility characteristics on EN. Both image quality metrics and volumetric measurements did not vary significantly (p > 0.05) with the range of turbo factors used in the study by one-way ANOVA analysis. Conclusion. Since no significant differences were observed in the performance of the turbo factors in terms of image quality and volume of brain structure, turbo factor 200 with a 74% acquisition time reduction was found to be optimal for brain MR imaging at 1.5 T. [ABSTRACT FROM AUTHOR]

Cross-sectoral collaboration is a widely used strategy in social and healthcare services. The main purpose of this way of working is to bring together organizations and their expertise to solve defined problems. A collective impact (CI)-based model is one of the promising approaches to create prerequisites for functional collaboration between different sectors. The CI-based cross-sectoral collaboration model has been implemented in the City of Oulu since the year 2019. During the implementation processes as well as underlined in the literature, the role of effective leadership has been highlighted as an essential prerequisite for the successful realization of CI-related work. Furthermore, the need for a research instrument to measure the realization of cross-sectoral collaboration including different CI-based domains and the effectiveness of leadership has been emphasized. The aim of this study was to evaluate the psychometric properties of a new research instrument developed for this purpose, named the Oulu cross-sectoral Collaboration and Leadership (OCL) scale. The OCL scale is based on the CI approach, with leadership as an additional domain. The psychometric properties of the OCL scale were evaluated for validity and reliability. Two-factor analyses with varimax rotation were performed to verify that the items included in each domain formed a homogeneous entity. The number of respondents in the online survey was 254, covering 37% of the target group of professionals. The Cronbach's alpha of the seven domains ranged from 0.875 to 0.929, reflecting good to excellent internal consistency. The results of the factor analyses showed that the items in all the domains of this research instrument work together as a group in an appropriate manner, measuring the same object. Suggestions for further development of the instrument are also presented. The OCL scale proved to be a promising tool for research purposes and for assessing collaborative development work of public services. This also gives an opportunity to measure changes in cross-sectoral collaboration during the CI-based implementation process. [ABSTRACT FROM AUTHOR]

Objectives. The aim of this study was to investigate the validity and reliability of the Turkish version of the National Comprehensive Cancer Network/Functional Assessment of Cancer Therapy Ovarian Symptom Index-18 (NFOSI-18) and Functional Assessment of Cancer Therapy/Gynecologic Oncology Group Neurotoxicity 4-item (NTX-4) in patients with advanced ovarian cancer (OC). Methods. Ninety-four women with OC were included. Pearson correlation coefficients were used to examine the convergent validity between the European Quality of Life Survey-5 Dimension-3 Level (EQ-5D-3L) and the Turkish NFOSI-18 and NTX-4. The internal consistencies of the Turkish NFOSI-18 and NTX-4 were calculated using Cronbach's alpha. Turkish NFOSI-18 and Turkish NTX-4 were readministered to 62 (67.4%) patients with OC after 14–21 days to evaluate test-retest reliability.Results. Turkish NFOSI-18 and Turkish NTX-4 showed excellent internal consistency (Cronbach's alpha: 0.919 and 0.917, respectively). The test-retest reliability of Turkish NFOSI-18 and Turkish NTX-4 was detected as good to excellent for total score (ICC [95%] = 0.93 [0.88-0.95] and ICC [95%] = 0.90 [0.85-0.94], respectively). Significant correlations were detected between the EQ-5D-3L total score, NFOSI-18 (r = 0.648, p < 0.01), and NTX-4 (r = 0.694, p < 0.01) indicating sufficient convergent validity. Conclusion. The Turkish NFOSI-18 and Turkish NTX-4 are reliable and valid tools to assess disease-related symptoms in patients with advanced OC. [ABSTRACT FROM AUTHOR]

Background. Parents' health literacy has a great impact on child's care and health. Knowing parent's health literacy levels is crucial to avoid the consequences of limited literacy and for the creation of better health policies and educational interventions. To assess those levels, we must have tools tailored to this population. However, there is a lack of specific instruments to evaluate this capacity in Portuguese parents of children aged less than 12 months. Aim. To perform the cultural adaptation and psychometric validation of the Parental Health Literacy Assessment Test-8 for use in Portugal. Methods. Methodological study is divided into two phases: cultural adaptation and psychometric validation. The first phase followed the Beaton guidelines. The second, carried out with 176 parents, took place at a public hospital in Portugal, between October 2020 and June 2021. Data were analyzed for internal reliability using the Kuder–Richardson reliability coefficient (KR-20). Confirmatory factor analysis was used to estimate factor validity, applying polychoric correlation measures using the "lavaan package" for the R statistical package. Results. In the cultural adaptation, the expert committee adjusted the translated version, validating the content for Portuguese parents. At validation, the calculated value of KR-20 was approximately 0.50. The empirical indices of the goodness-of-fit of the factor model showed a good overall fit, although two of the items had low weights (0.24 and 0.32). The results of the factors show an acceptable value for the factor (FC = 0.756) and a lower value for the average variance extracted. Conclusion. The version of the instrument adapted for Portugal presented adequate semantic and content equivalence. The psychometrics suggested that the PHLAT-8-PT is a reliable and valid instrument that can be used systematically by the health team to measure the health literacy levels and improve health education. [ABSTRACT FROM AUTHOR]

Background. Strategic leadership is key to implementing evidence-based practice (EBP). Evaluating the readiness and processes necessary to implement EBP using the Japanese version of the implementation leadership scale (ILS) may be useful to systematically promote the implementation of EBP in Japan. This study aimed to evaluate the reliability and validity of the Japanese version of the ILS for nurse managers and staff nurses. Methods. Data were collected in a cross-sectional study. The original ILS was translated into Japanese and back-translated into English. Clinical nurses reviewed it and confirmed its face validity. We distributed a web questionnaire to 119 nurse managers and 2,858 staff nurses working at three university hospitals in Japan's metropolitan areas. Construct validity was assessed for nursing managers and staff nurses, respectively, using confirmatory factor analysis. Known-group validity for nurse managers was assessed by verifying differences in ILS scores by educational background and experience of learning EBP and working on EBP. We evaluated reliability using Cronbach's alpha and test-retest reliability. Results. The response rates for nurse managers and staff nurses were 56.3% and 16.9%, respectively. Data from 67 nursing managers and 484 staff nurses were analyzed, excluding duplicate responses. Confirmatory factor analyses of both samples supported the four-factor structure of ILS. The ILS total score of nurse managers with experience learning EBP or experience working on EBP was statistically significantly higher than that of those with no experience, and known-group validity was supported. Across both samples, internal consistency reliability was strong (Cronbach's alpha: 0.91–0.97) and test-retest reliability was moderate. Conclusion. This study illustrated the reliability and validity of Japanese versions of the ILS for both nurse managers and staff nurses. This study enabled international comparisons of the leadership required for EBP implementation and may support the development of intervention programs and strategies to promote EBP's implementation in different countries. Trial Registration. UMIN Clinical Trials Registry (UMIN-CTR). This trail is registered with UMIN000045782. [ABSTRACT FROM AUTHOR]

Background. There is a narrow therapeutic window for sodium valproate, and the blood concentration is too low to control epilepsy, while it is easy to poison the body if the concentration is too high. It is therefore necessary to monitor drug concentration reasonably in order to control epilepsy. The purpose of this study was to establish a model for predicting concentrations of sodium valproate below 50 μg/mL in children with epilepsy. Methods. The clinical data and biochemical examination results of children with epilepsy treated in the pediatric outpatient department of our hospital from June 2019 to March 2022 were retrospectively collected and divided into a development group and a validation group according to a patient ratio of 8 to 2. Five machine learning algorithms were used to identify the key variable factors, and a risk prediction model for sodium valproate blood concentrations lower than the standard concentration was established. The area under the curve (AUC), calibration curve, GiViTi calibration band, and clinical influence curve were used to evaluate the diagnostic efficacy and clinical application value of the model. Results. A total of 525 children with epilepsy were enrolled. In the development group, the random forest algorithm performed best in predicting that the blood concentration of sodium valproate was lower than the standard concentration, showing the highest AUC (1.00). Six factors were determined as a nomogram to predict the incidence of low concentrations. In the validation group and the development group, the calibration curve, GiViTi calibration band, and clinical influence curve all performed well in the evaluation of the diagnostic efficacy and clinical application value of the model. Conclusions. This finding highlights the importance of examining biochemical indices in patients when data regarding the blood concentration of sodium valproate are lacking. [ABSTRACT FROM AUTHOR]

Objectives. This study is aimed at evaluating the diagnostic performance of clinical predictors and the Doppler ultrasonography in predicting esophageal varices (EV) in patients with hepatitis C-related cirrhosis and exploring the practical predictors of EV. Methods. We conducted a prospective study from July 2020 to January 2021, enrolling 65 patients with mild hepatitis C-related cirrhosis. We obtained clinical data and performed grayscale and the Doppler ultrasound to explore the predictors of EV. Esophagogastroduodenoscopy (EGD) was performed as the reference test by the gastroenterologist within a week. Results. The prevalence of EV in the study was 41.5%. Multivariable regression analysis revealed that gender (female, OR = 4.04 , p = 0.02), platelet count (<150000 per ml, OR = 3.13 , p = 0.09), splenic length (>11 cm, OR = 3.64 , p = 0.02), and absent right hepatic vein (RHV) triphasicity (OR = 3.15 , p = 0.03) were significant predictors of EV. However, the diagnostic accuracy indices for isolated predictors were not good (AUROC = 0.63 –0.66). A combination of these four predictors increases the diagnostic accuracy in predicting the presence of EV (AUROC = 0.80 , 95% CI 0.69-0.91). Furthermore, the Doppler assessment of the right hepatic vein waveform showed good reproducibility (κ = 0.76). Conclusion. Combining clinical and Doppler ultrasound features can be used as a screening test for predicting the presence of EV in patients with hepatitis C-related cirrhosis. The practical predictors identified in this study could serve as an alternative to invasive EGD in EV diagnosis. Further studies are needed to explore the diagnostic accuracy of additional noninvasive predictors, such as elastography, to improve EV screening. [ABSTRACT FROM AUTHOR]

Objective. This study aimed to develop and perform a content validation of a brief French tool for self-assessment of supportive and palliative care needs in patients with cancer, using four different approaches: issue's importance, problem intensity, problem burden, and expressed need for help. Methods. Items, questions, and response scales were based on a literature review and discussions within a multidisciplinary scientific committee. A panel of experts evaluated the relevance, comprehensiveness, and comprehensibility of each item and question using the Delphi method. These properties were also assessed through cognitive debriefing interviews with cancer patients. Results. Eleven domains were selected from the literature review: physical, role, social, psychological, patient care and support, healthcare, information, financial, activities of daily living, spirituality, and sexuality. A scientific committee created 15 items and five questions. Two Delphi rounds were required to reach a consensus among the 29 experts on a pilot version. Twenty-three cancer patients were involved in the cognitive debriefing interviews. All items and questions were considered as relevant. Acceptability was good, and four items were reformulated based on patients' comments. Conclusion. This brief French tool has a very good content validity and can be used in clinical practice. [ABSTRACT FROM AUTHOR]

Background. A nursing work method is the base for the organization and implementation of nursing care to patients based on nurses' skills. Nurses' work methods are consensually organized into two groups: task-oriented work methods (functional method) and client-centered work methods (teamwork method, individual work method, and work method per reference nurse). As for the impact of the work method on clients, we highlight the interference in the quality of care provided and, regarding nurses, the impact on workload and job satisfaction. Therefore, the existence of tools that allow identifying the organizational methodologies of nursing care is relevant. Aim. The aim of the study is to test the validity and reliability of the nurses work methods assessment scale (NWMAS). Methods. The methodological study followed the recommendations of the EQUATOR network. The NWMAS was previously developed as a self-completion questionnaire. To determine construct validity, exploratory and confirmatory factor analyses were performed. Results. 325 participants were enrolled in this study. In exploratory factor analysis, the 25 items comprising NWMAS were distributed in five dimensions, contemplating the work methods. Cronbach's alpha of the total scale was 0.846. The confirmatory factor analysis revealed a good fit. Conclusion. The NWMAS is a valid and reliable tool. Implications for Nursing Practice. The NWMAS identifies the work methods adopted by nurses in hospital settings, is a valuable tool for nursing management, and contributes to the definition of strategies that promote the quality of nursing care and the safety of patients. [ABSTRACT FROM AUTHOR]

Background. Worldwide, hospitals are required to prioritize the culture of quality in infection prevention (CQIP) for patient safety. Assessing CQIP is crucial, but there is limited research, especially regarding nurses' perceptions. Insufficient information exists due to scarcity of validated instruments in local languages to measure CQIP internationally. Purpose. This study assessed the "Leading a Culture of Quality in Infection Prevention Scale" Russian version's (LCQ-IPS-R) validity and reliability to assess the CQIP of hospitals in Kazakhstan based on nurses' perceptions. Methods. This study utilized a methodological design and analyzed data from 204 nurses at the "National Research Center for Maternal and Child Health" in Astana City, Kazakhstan. The "cultural and linguistic adaptation" process involved a "forward-backward translation" technique. Content validity and construct validity were examined. Internal consistency reliability was explored for scale reliability. Results. The scale's mean item range was from 3.56 (SD = 1.22) to 4.40 (SD = 0.85; SD = 0.92). The corrected item-total correlation ranged from 0.321 to 0.707. Six experts rated the I-CVI from 0.83 to 1.00, with an S-CVI/Ave of 0.90. The principal component analysis with Varimax rotation produced four distinct components of the LCQ-IPS-R, explaining 69.8% of the total variance. The tests of correlation between the LCQ-IPS-R's four components revealed medium to large positive associations among the components (r = 0.25–0.55, p < 0.001). The computed α for the LCQ-IPS-R was 0.909 while α values from four subscales ranged from 0.809 to 0.921. Conclusions/Implications for Practice. This study provides evidence of the LCQ-IP-R's reliability and validity in evaluating Russian-speaking nurses' perception of their hospital's CQIP. These findings open the door for further research on CQIP in healthcare settings in Kazakhstan, Central Asia, and other Russian-speaking countries. The scale provides essential baseline information to design effective interventions for achieving hospitals' infection prevention objectives. [ABSTRACT FROM AUTHOR]

Background. Unintended pregnancy refers to a pregnancy that is either mistimed or unwanted. Unintended pregnancy has been a troubling public health and reproductive health issue, which imposes appreciable adverse consequences on the mother, child, and the public in general. Globally 121 million unplanned pregnancies occurred from 2015 to 2019. A significant proportion (61%) of these pregnancies ended in abortions each year. In Ethiopia, the challenges of unintended pregnancy and its related complications still exist because of the high rate of unmet need for contraceptives. In addition, no research has been conducted on unintended pregnancy among pregnant women in Dire Dawa city administration. Objective. To determine the prevalence of unintended pregnancy and associated factors among pregnant women attending antenatal care public health facilities in Dire Dawa in 2021. Methods. A facility-based cross-sectional study was conducted. After being chosen randomly, 382 pregnant women were interviewed at 9 urban public health facilities. A pretested questionnaire was used to collect data, entered into Epi Info 7, and exported into SPSS version 25 for analysis. The variables, which were significant at P ≤ 0.25 in bivariate analysis, were included in multivariable analysis. Statistical significance was declared at a P value <0.05 and a 95% CI. Results. In this study, the prevalence of unintended pregnancy was 23.8% at 95% CI (19.8–28.3). The following factors were associated with unintended pregnancy: single women (AOR = 10.93, 95% CI 3.65–32.74), low family income (2000 ETB) (AOR = 4.01, 95% CI 1.73–9.28), parity 3 (AOR = 10.3, 95% CI 4.07–25.84), no history of family planning use (AOR = 5.91, 95% CI 2.46–14.21), and husband decision-making role on reproductive health (AOR = 2.956, 95% CI 1.048–8.340). Conclusion and Recommendations. The prevalence of unintended pregnancy was relatively high in this study. Efforts should be made to scale up women's decision-making power on family planning services and give support to empower women economically. There is the need to promote family planning services to minimize unintended pregnancy and to decrease parity and family size. [ABSTRACT FROM AUTHOR]

Purpose. This study aimed to develop a group organizational learning activity inventory for evidence-based practice (EBP) institutionalized by hospitals and to verify its reliability and validity. Methods. A draft inventory was created after verifying content and face validity of draft items developed based on interview data and materials used in EBP implementation. Construct validity and reliability were assessed cross-sectionally through an anonymous self-administered survey conducted via web and printed questionnaires. Construct validity was confirmed using exploratory and confirmatory factor analyses, and internal consistency and convergent/discriminant validity were verified. Inventory structure was determined using the theoretical model based on the hypothetical constructive concept. Temporal stability was assessed two weeks after the initial survey. Result. A draft inventory comprising 12 factors and 47 items was created based on 95 draft items. Data from 371 nurses across 55 departments in 12 hospitals were analyzed. The inventory comprised 8 factors and 40 items based on the theoretical model. The comparative fit index was 0.86, the Tucker–Lewis index was 0.85, the root mean square error of approximation was 0.09, and standardized root mean square was 0.04. Cronbach's alpha of each factor was ≥0.8, and the temporal stability was moderate. Conclusion. We developed the group organizational learning activity inventory, comprising 8 factors and 40 items. Though construct validity was low, the reliability and concurrent/convergent validities were confirmed. This inventory contains new factors that measure the group activities to ensure EBP's continuation in hospitals: forming common knowledge, understanding the value of EBP in groups, and fostering ownership thereof. Using this inventory, departments that introduced EBP can evaluate the extent of activities leading to nurses' continuation of EBP and find the improvement point. [ABSTRACT FROM AUTHOR]

Aim. To examine the reliability and validity of the Indonesian translation of the McCloskey/Mueller Satisfaction Scale. Background. The McCloskey/Mueller Satisfaction Scale is an instrument to measure nurses' feelings about their job. Although the instrument has existed for a long time, there has been a lack of studies using this questionnaire in Indonesia due to the limitation of instrument validation in the Indonesian version. Therefore, it is necessary to investigate the validation and reliability of the instrument. Methods. The instrument was validated with a cross-sectional study of 350 nurses. For purposes of transcultural adaptation and psychometric validation, a forward-back translation strategy was used in conjunction with an expert panel and a cross-sectional study. The validity of the construct was verified using confirmatory factor analysis, and the overall fit of the model was measured using the calculated fit indices. The standard deviation of the extracted variance was used to evaluate the convergence validity. Composite reliability and Cronbach's alpha coefficients were used to investigate the internal consistency of the study. Results. According to the results of the reverse translation, the Indonesian and original instruments are statistically indistinguishable. As a result of the confirmatory factor analysis, it was determined that the Indonesian version of the McCloskey/Mueller Satisfaction Scale adhered closely to the original structure of the English version. The convergence validity of the construct (0.44–0.74), reliability (Cronbach α = 0.69–0.93), and internal consistency (0.49–0.79) were rated highly. Conclusions. Good homogeneity and construct validity have been shown for the Indonesian translation of the McCloskey/Mueller Satisfaction Scale in the context of healthcare practice and research. Implications for Nursing Management. Nursing policymakers in Indonesia can use the instrument to inform the development of practice policies aimed at improving job satisfaction among nurses in the country. [ABSTRACT FROM AUTHOR]

Background. The high turnover rate of new nurses is significantly impacted by the transition issue. Practice readiness has been identified as a key factor in ensuring a smooth transition, but there is currently a lack of specific instruments available in China to measure it. Aims. To translate and adapt the Casey-Fink Readiness for Practice Survey and validate its psychometric properties in senior nursing students in the Chinese cultural context. Methods. The descriptive cross-sectional study design was used. The English version of the Casey-Fink Readiness for Practice Survey was translated into Chinese according to Brislin's translation guidelines. A total of 590 senior nursing students from three nursing schools in China were surveyed with the Chinese version of the Readiness for Practice Instrument. Data analyses were performed to assess the reliability and validity of the instrument. The STROBE guidelines were used as the reporting method. Results. The validated Chinese version of the Casey-Fink Readiness for Practice Survey contained 18 items in the same four dimensions as the original English version. The internal consistency was satisfactory, with Cronbach's α and composite reliability values for all four dimensions above 0.70. The final confirmatory factor analysis model also demonstrated good fit indices, with the average variance extracted values for all dimensions above 0.50. Conclusion. The validated Chinese version of the Casey-Fink Readiness for Practice Survey is a reliable and effective instrument for measuring the readiness for practice among senior nursing students in China. Implications for Nursing Management. This study presents a valuable contribution to adapting an effective and reliable tool to assess readiness for practice among Chinese senior undergraduate nursing students. This will enable the development of specific strategies based on cultural context to optimize the readiness for practice for senior nursing students and smooth the transition of new nurses in China. [ABSTRACT FROM AUTHOR]

Aim. This paper aimed to examine the current state of nurse safety behavior, and the effect of work engagement on it, and to explore the mediating effect of self-efficacy between work engagement and nurse safety behavior in specialized cancer hospitals. Background. Nurse safety behavior affects the quality of care and outcomes for patients with cancer. The research proves that self-efficacy is associated with work engagement, but the relationship between self-efficacy, work engagement, and nurse safety behavior needs to be clarified. Methods. This study used a convenience sampling method to survey 957 nurses from January to February 2023. The survey included tertiary specialized cancer hospitals in five provinces in China. Sociodemography information, the Work Engagement Scale, the Self-Efficacy Scale, and the Nurse Safety Behavior Scale were used for the survey. A Questionnaire Star program collected all the data automatically. The Statistical Package for the Social Sciences version 24 was employed for Pearson correlation and multiple regression analysis to examine the association between work engagement, self-efficacy, and nurse safety behavior. Structural equation models were built using Analysis of Moment Structures version 24.0 software. Results. The results showed that the nurse safety behavior was at a high level in specialized cancer hospitals. There was a significant positive relationship between the variables work engagement, self-efficacy, and nurse safety behavior with coefficients ranging from 0.244 to 0.564. The results of structural equation modeling revealed that self-efficacy partially mediated the effect between work engagement and nurse safety behavior, accounting for 25.3% of the total effect. Conclusion. Self-efficacy mediates the relationship between work engagement and nurse safety behavior, and by increasing self-efficacy, nurse safety behavior can be improved, thus ensuring patient safety. Implications for Nursing Management. Managers should promote high work engagement and nurse safety behaviors by fostering nurses' self-efficacy. [ABSTRACT FROM AUTHOR]