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Competing Interests: Declaration of competing interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper.

Objectives: Good oral hygiene is essential for schoolchildren's well-being. However, lack of knowledge, negative attitudes, and poor oral hygiene practices may predispose to oral-related diseases. This study aimed to examine the effectiveness of a nurse-led oral hygiene program on schoolchildren's knowledge, attitudes, and practices., Design: A quasi-experimental design with pre-and-post-test was used., Sample: Using the convenience sampling technique, we recruited 400 schoolchildren, aged 11-12 and in grades 5-6, from two primary schools in Egypt., Methods: The study was conducted from September 2022 to May 2023. The Oral Hygiene Program served as the primary intervention. This program contains health education topics (e.g., the importance of oral hygiene, techniques for effective tooth brushing, and dietary choices that promote dental health). Three visits were conducted (Visit 1: introduction of the program purpose and objectives and pre-test scores collection, Visit 2: implementation of oral hygiene topics, and Visit 3: post-test scores collection). We used three self-report instruments (Oral Health Knowledge Questionnaire, Hiroshima University's Dental Behavioral Inventory, and Oral Health Practice Questionnaire) for pre- and post-test. Paired T test and Pearson correlation analysis were used for data analysis., Results: After the intervention program, the oral hygiene program effectively enhanced schoolchildren's knowledge, attitudes, and practices. The post-intervention mean scores were 7.83 ± 0.488 (knowledge), 6.63 ± 1.7 (practices), and 9.33 ± 1.1 (attitudes). High statistically significant differences were noted between schoolchildren's oral health knowledge, attitudes, and practices before and after implementing the program (p = 0.000)., Conclusion: There were enhancements in the level of knowledge, with improved positive attitudes and satisfactory practices among schoolchildren after the implementation of the oral hygiene program. Integrating oral hygiene programs into the general curriculum in primary schools and training school nurses, caregivers, and teachers in implementing oral hygiene programs could improve oral health knowledge, attitudes, and practices for preventing oral problems., (© 2024 Wiley Periodicals LLC.)

Aims: To investigate how nursing students' professional identity, clinical learning environment, financial incentives, and career opportunities influence their intention to migrate., Background: There is a preponderance of studies about nurse migration and its impact on the global nursing workforce. However, a critical gap remains about nursing students' intentions to migrate, particularly among developing countries like the Philippines., Methods: Using a cross-sectional design, third- and fourth-year nursing students (n = 316) from the largest comprehensive university in Manila were conveniently recruited. Data were collected from November to December 2023 using five validated self-report scales. Descriptive (e.g., mean, standard deviation) and inferential statistics (e.g., Spearman rho, covariance-based structural equation modeling) were used to analyze data., Results: The emerging model demonstrated acceptable model fit indices. Nursing students' professional identity (β = 0.18, p = 0.043) and financial incentives (β = 0.10, p = 0.046) significantly and positively influence the intention to migrate. The satisfaction with future career opportunities (β = -0.12, p = 0.038) and clinical learning environment perception (β = -0.15, p = 0.048) negatively influence the intention to migrate. These four predictors accounted for 4.60% of the total variance of intention to migrate., Conclusion: Nursing students' professional identity and financial incentives directly impact intent to migrate, whereas future career opportunities satisfaction and clinical learning environment inversely affect intent to migrate., Implications for Nursing Practice and Policy: This study underscores the imperative for nursing colleges and faculty to promote positive professional identity and provide a conducive clinical learning environment to develop sustainable nurses' migration policies., (© 2024 International Council of Nurses.)

Background: Globally, nurses' patient safety, care quality, and missed nursing care are well documented. However, there is a paucity of studies on the mediating roles of care quality and professional self-efficacy, particularly among intensive and critical care unit (ICCU) nurses in developing countries like the Philippines., Aim: To test a model of the interrelationships of patient safety, care quality, professional self-efficacy, and missed nursing care among ICCU nurses., Methods: A cross-sectional, correlational design study was used. ICCU nurses (n = 335) were recruited via consecutive sampling from August to December 2023 and completed four validated self-report scales. Spearman Rho, structural equation modeling, mediation, and path analyses were utilized for data analysis., Results: The emerging model demonstrated acceptable fit parameters. Patient safety positively influenced care quality (β = .34, p = .002) and professional self-efficacy (β = .18, p = .011), while negatively affecting missed nursing care (β = -.34, p = .003). Care quality positively and negatively influenced professional self-efficacy (β = .40, p = .003) and missed nursing care (β = -.13, p = .003), respectively. Professional self-efficacy indirectly impacted missed nursing care (β = -.32, p = .003). Care quality (β = -.10, p = .003) and professional self-efficacy (β = .13, p = .003) showed mediating effects between patient safety and missed nursing care., Linking Evidence to Action: ICCU nurses' care quality and professional self-efficacy are essential mediating factors that can bolster patient safety practices, hence reducing missed nursing care. Therefore, healthcare organizations, nurse managers, and policymakers should cultivate care quality and self-efficacy by creating support programs and providing a positive practice environment. Nurses and nurse supervisors could directly observe missed nursing care in the ICCU to understand its underreported causes., (© 2024 Sigma Theta Tau International.)

Aims: To investigate the interrelationships of patient safety, caring behaviours, professional self-efficacy and missed nursing care among emergency room nurses., Design: Cross-sectional, correlational study., Methods: Filipino emergency room nurses (n = 345) participated via convenience sampling from September 2023 to January 2024. Four validated self-report scales were used to collect data and were analysed using Spearman rho, covariance-based structural equation modelling, mediation and path analyses., Results: The emerging model of study variables displayed satisfactory fit indices. Patient safety directly influenced caring behaviours and professional self-efficacy, while negatively influencing missed nursing care. Caring behaviours directly and indirectly affected professional self-efficacy and missed nursing care, respectively. Professional self-efficacy negatively influences missed nursing care. Finally, caring behaviours and professional self-efficacy were significant mediators between the association of patient safety and missed nursing care., Conclusion: Caring behaviours and professional self-efficacy of emergency room nurses demonstrated mediating effects that can potentially improve patient safety practices thereby minimizing unfinished or missed nursing care., Implications for the Profession And/or Patient Care: Nurses and healthcare organizations should commit to consistently maintain a workplace culture that fosters patient safety, caring behaviours and professional self-efficacy to minimize avoidable injuries and omitting nursing care tasks., Reporting Method: STrengthening the Reporting of OBservational studies in Epidemiology (STROBE)., Patient or Public Contribution: No Patient or Public Contribution., (© 2024 John Wiley & Sons Ltd.)

Aims: The aim was to investigate the interrelationships of nurses' safety climate, quality of care, and adherence to and compliance with standard precautions (SPs)., Background: Investigations about nurses' safety climate and quality care and their association with adherence to and compliance with SPs remain remarkably scant across literature, specifically among developing countries like the Philippines., Design: Cross-sectional design and structural equation modeling (SEM) approach while complying with STROBE guidelines., Methods: Participant nurses were recruited using convenience sampling (n = 870). Four validated self-report instruments were used to collect data from February to August 2022. Spearman rho, SEM, mediation, and path analyses were employed for data analysis., Results: The emerging model showed acceptable model fit parameters. The safety climate positively influenced the quality of care and adherence to and compliance with SPs. Quality of care directly affected adherence to SPs, while adherence to SPs directly affected compliance with SPs. The quality of care mediated the relationship between safety climate and adherence to SPs. Whereas adherence to SPs mediated the relationships between safety climate and compliance with SPs and the quality of care and compliance with SPs., Conclusions: Nurses' safety climate directly affected the quality of care and SPs adherence and compliance. The quality of care mediated the impact of safety climate on SPs adherence. Finally, SPs adherence demonstrated a mediating effect among quality of care, safety climate, and SPs compliance., Implications for Nursing Policy and Practice: Nursing policymakers and administrators can use the findings to design strategic policies and sustainable in-service educational courses fostering and maintaining nurses' safety climate, quality of care, and SPs adherence and compliance., (© 2024 International Council of Nurses.)

Introduction: Investigations about the interrelationships of nurses' safety climate, quality of care, and standard precautions (SP) adherence and compliance remain particularly scarce in the literature. Thus, we tested a model of the associations between nurses' safety climate, quality of care, and the factors influencing adherence and compliance with SPs utilizing the structural equation modeling (SEM) approach., Design: Cross-sectional design complying with STROBE guidelines., Methods: Using convenience sampling, nurses (n = 730) from the Philippines were recruited. Data were collected between April and September 2022 using four validated self-report measures. Spearman Rho, mediation and path analyses, and SEM were employed for data analysis., Results: Acceptable model fit indices were shown by the emerging model. The safety climate is positively associated with quality of care and factors influencing adherence to and compliance with SPs. Quality of care directly affected factors influencing adherence to SPs. The factors influencing adherence to SPs directly affected SP compliance. Quality of care mediated between safety climate and the factors influencing adherence to SPs. Factors influencing adherence to SPs mediated between safety climate, quality of care, and SP compliance., Conclusions: The study's variables are not distinct but overlapping nursing concepts that must be examined collectively. Nurse administrators can utilize the emerging model to formulate strategies and regulations for evaluating and enhancing nurses' safety climate, quality of care, and SP adherence and compliance., Clinical Relevance: Our findings may impact policymaking, organizational, and individual levels to improve nurses' clinical practice., Patient or Public Contribution: This study had no patient contribution or public funding., (© 2024 Sigma Theta Tau International.)

Investigations about moral resilience and moral courage as mediators between moral distress and moral injury remain underreported among nurses during the COVID-19 pandemic. Nurses (n = 412) from the Philippines were conveniently recruited via social media platforms and completed four self-report scales. The mediation model depicts that moral distress negatively impacts moral resilience and moral courage while positively affecting moral injury. Moral resilience and moral courage negatively impact moral injury, whereas moral resilience directly impacts moral courage. Finally, moral resilience and moral courage demonstrated a mediating effect between moral distress and moral injury. Findings indicate that healthcare organizations and nurse managers should nurture morally resilient and courageous therapeutic practices among frontline healthcare professionals to mitigate the negative effects of moral distress and moral injury., (© 2023. The Author(s), under exclusive licence to Springer Science+Business Media, LLC, part of Springer Nature.)

Nursing students' stress, protective factors (e.g. resilience, social support, mindfulness and self-efficacy) and psychological well-being (PWB) have been well reported in the literature. However, the interactions of these variables were scarcely examined in the latter part of the COVID-19 pandemic and in the context of a developing country. This cross-sectional correlational study complying with STROBE guidelines tested a hypothetical model of the interrelationships of nursing students' stress, protective factors and PWB using structural equation modelling (SEM). Nursing students (n = 776) from five nursing schools in the Philippines were conveniently recruited from September 2022 to January 2023. Six validated self-report scales (Perceived Stress Scale, Multi-dimensional Scale of Perceived Social Support, Generalized Self-Efficacy Scale, Connor-Davidson Resilience Scale, Mindful Attention Awareness Scale, and Psychological Wellbeing Scale) were used to collect data. SEM, mediation analyses and path analyses were used for data analysis. The emerging model demonstrated acceptable model fit parameters. Stress negatively impacted protective factors, while all the protective factors positively influenced PWB. Social support mediated the influence of stress on resilience, mindfulness and PWB. Resilience is a significant mediator of stress, self-efficacy, social support and PWB. Mindfulness mediated the influence of stress, social support and self-efficacy on PWB. Finally, self-efficacy had a mediating role between resilience and mindfulness. Nursing institutions and nurse educators can use the proposed model as their basis for empirical and theoretical evidence in creating programmes that will strengthen nursing students' protective factors, thus reducing stress while improving PWB and learning outcomes., (© 2023 John Wiley & Sons Australia, Ltd.)

Aims and Objectives: To explore the relationship between Saudi nurses' professional values and competence., Background: Professionals are bound by ethical standards specific to their profession. Accordingly, the COVID-19 pandemic is the most significant event that has impacted nurses' professional values and competency., Design: A descriptive cross-sectional design adhering to STROBE guidelines., Methods: Clinical nurses from four tertiary government hospitals (n = 659) participated and completed two self-report instruments. Study variables were analysed using the structural equation modelling approach., Results: The emerging model displayed acceptable model fit indices. Professionalism and activism were two dimensions of nurse professional values that significantly impacted professional competency. Professionalism significantly impacted the four other aspects of nurse professional values: caring, activism, trust, and justice. Caring had a significant and direct impact on activism. Activism had a weak, direct effect on trust, whereas justice had a moderate, direct effect on trust. Through the mediation of the dimension of activism, both the dimensions of professionalism and caring had a strong, indirect impact on professional competency., Conclusions: This research presents a structural model of the interrelationship between nurse professional values and competency. Nurse administrators can use the proposed model to develop approaches and policies for assessing, improving and evaluating professional values among nurses., Relevance for Clinical Practice: Nursing professionals are committed to upholding their ethical and moral standards while performing their caregiver roles. Nurse administrators can implement activities and strategies to develop nurses' professional competence further, as professional values represent the ideal values expected of nurses providing patient care., (© 2022 John Wiley & Sons Ltd.)

Aims: To investigate the mediating role of moral resilience and moral courage in the association between moral distress and moral injury., Background: There is a preponderance of nursing literature about moral distress, moral resilience, moral courage and moral injury. However, examining moral resilience and moral courage as mediators remain underreported during the COVID-19 pandemic and in the context of a developing nation., Design: Correlational, cross-sectional design compliant with the STROBE guidelines., Methods: A convenience sample of nurses (n = 412) from the Philippines were recruited using social media platforms (e.g., Facebook, Messenger, Twitter). Four self-report and validated scales (8-item Moral-Distress Appraisal Scale, 21-item Nurses' Moral Courage Scale, 17-item Rushton Moral Resilience Scale and 10-item Moral Injury Symptom Scale: Healthcare Professionals Version) were used to collect data from January to July 2022. Pearson's r, bivariate analysis and multistage regression analyses were used for data analysis., Results: This study afforded a model that depicted the interrelationships of moral distress, moral resilience, moral courage and moral injury. Moral distress has a negative impact on moral resilience and moral courage while positively affecting moral injury. Moral resilience positively influences moral courage while having a negative impact on moral injury. Moral courage has an indirect impact on moral injury. Finally, moral resilience and moral courage demonstrated a mediating effect between moral distress and moral injury., Conclusions: Healthcare organizations, policymakers and nurse managers should include policies and programs that include improving approaches to modifying workplace conditions and evaluating nurses' moral resilience and courage. Nurse managers need to advocate ethics education and professionalism. Nurses must practice self-care strategies to strengthen morally resilient and courageous therapeutic practices., Competing Interests: Declaration of Competing Interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2023 Elsevier Ltd. All rights reserved.)

Aim: To translate the Nurse Professional Competence Scale-Short Form English version into Arabic and psychometrically validate its properties among Saudi citizen nurses., Background: Evaluating nurses' professional competence is vital in delivering safe, cost-effective care and developing healthcare systems. However, psychometrically reliable and validated nurse competence scales in Arabic-speaking countries remain scant., Design: A descriptive cross-sectional design adhering to the Strengthening the Reporting of Observational Studies in Epidemiology guidelines., Methods: Participant nurses (n = 598) were conveniently recruited from four government-owned hospitals and completed the Arabic-translated 35-item Nurse Professional Competence Scale-Short Form. We used Spearman's rank-order correlation, exploratory factor analysis, Kaiser-Meyer-Olkin test, and confirmatory factor analysis to analyze the data., Results: After exploratory factor analysis and reliability analyses, several items of the Arabic-translated 35-item Nurse Professional Competence Scale-Short Form were omitted due to high inter-item correlations and low factor loading difference. The Arabic version of the Nurse Professional Competence Scale-Short Form was reduced to 21 items, consisting of a three-factor structure: Professional Care Pedagogics, Holistic Value-Based Care, and Direct Nursing Care. Results also demonstrated that the revised three-factor structure had good overall scale reliability, good subscale internal consistencies, and acceptable construct validity using the confirmatory factor analysis., Conclusion: The 21-item Nurse Professional Competence Scale-Short Form Arabic version is a useful scale, having demonstrated construct validity and reliability. Therefore, nurse managers in Arabic-speaking nations could assess their nurses' professional competence using the 21-item Nurse Professional Competence Scale-Short Form Arabic version to develop proactive programs that enhance professional competence., Competing Interests: Declaration of Competing Interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2023 Elsevier Ltd. All rights reserved.)

Aims: In July 2022, the human monkeypox virus was declared by the World Health Organization, a public health emergency of global concern. This study investigated the Filipinos' knowledge of monkeypox and determined the demographic variables that predicted it., Design: Correlational and cross-sectional design adhering to STROBE guidelines., Methods: Participants were recruited conveniently through social media platforms (n = 575). This study used a 21-item monkeypox knowledge survey questionnaire to collect data from July to September 2022. Logistic regression analysis was used to analyse the data., Results: Most participants (53.74%) were above 30 years old, females (68.87%), residing in Luzon (54.96%), college graduates (61.04%), Catholics (78.61%) and employed (68%). Social media, particularly Facebook (57.91%), is the common source of monkeypox-related information (78.61%). Participants' age (>30 years old) is the only predictor of monkeypox infection knowledge (aOR: 3.13; 95%CI: 1.25-7.87, p = .015). They are three times more likely to be knowledgeable than those under 30., Conclusion: The findings highlight the importance of evidence-based strategies for increasing public knowledge and awareness. The government, healthcare workers and the public should adopt proactive preventive measures against human monkeypox to prevent future pandemics., Patient or Public Contribution: No patient or public contribution has been made in this study., Impact Statement: What problem did the study address? Assessing people's knowledge about monkeypox will help the government and healthcare workers (HCWs) create policies to prevent the spread of the virus. To the best of my knowledge, this is the first study that used a national online survey to assess Filipinos' human monkeypox knowledge. What were the main findings? Most participants had insufficient knowledge of the monkeypox infection. Participants' primary source of monkeypox infection information is social media, specifically Facebook. Participants older than 30 had higher knowledge of monkeypox infection. Where and on whom will the research have impact? Raising public awareness and knowledge about monkeypox disease prevents viral transmission in the community. HCWs (e.g., nurses, midwives, and doctors) should report monkeypox patients to appropriate health authorities. Standard and droplet precautions should be practiced and taught to the public to prevent the virus' spread. The government and HCWs should intensify monkeypox awareness programs to increase the public's knowledge and awareness of the disease. They can utilize social media platforms to disseminate correct and relevant information., (© 2023 John Wiley & Sons Ltd.)

Aim: To investigate the interrelationships of nomophobia, social media use, attention, motivation, and academic performance among nursing students., Background: There is a preponderance of studies about nursing students' nomophobia, social media use, and academic performance. However, the mediating role of motivation and attention between nomophobia and academic performance remains a blind spot in nursing literature., Design: Cross-sectional design and structural equation modeling (SEM) approach., Method: Students from five nursing institutions in the Philippines were recruited via convenience sampling (n = 835). We used STROBE guidelines in reporting this study. Three self-report instruments (Motivational Strategies for Learning Questionnaire [MSLQ], Media and Technology Usage and Attitude Scale [MTUAS], and Nomophobia Questionnaire [NMP-Q]) were used to collect data. SEM, mediation analyses, and path analyses were used for data analysis., Results: The emerging model afforded acceptable model fit indices. Nursing students' nomophobia positively influenced social media use whereas negatively impacting motivation and attention. Social media use, motivation, and attention directly affect academic performance. Path analyses depicted that motivation and attention mediated the indirect effect of nomophobia on academic performance. Motivation mediated the indirect impact of nomophobia on attention. Finally, attention mediated the indirect effect of motivation on academic performance., Conclusion: Nursing institutions and educators can use the proposed model in developing guidelines for evaluating nomophobia and regulating social media use in the academic and clinical context. These initiatives could support nursing students' transition from school to practice while assisting them in maintaining their academic performance., Competing Interests: Declaration of Competing Interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2023 Elsevier Ltd. All rights reserved.)

Aims: To investigate the mediating role of resilience and academic motivation between academic stress and self-directed learning., Background: Academic stress in nursing students is a well-reported concept that affects resilience, academic motivation and self-directed learning. However, there is a dearth of studies investigating the mediating role of resilience and academic motivation between academic stress and self-directed learning., Design: Cross-sectional study and mediation analysis., Methods: Nursing students (n = 718) were recruited from five nursing schools via convenience sampling. Four self-report scales (Perception of Academic Stress Scale, Connor and Davidson Resilience Scale, Short Academic Motivation Scale and Self-directed Learning Instrument) were used to collect data from August to December 2022. Pearson's r, bivariate analysis and multistage regression analyses were employed to analyze the data., Results: Academic stress negatively influences nursing students' resilience, academic motivation and self-directed learning. Resilience and academic motivation have a positive impact on self-directed learning. Resilience and academic motivation mediate the relationship between academic stress and self-directed learning, as evidenced by a reduction in the negative impacts of academic stress on nursing students., Conclusion: Resilience and academic motivation, as mediators, reduce the effects of academic stress on self-directed learning. Nursing educators and administrators should promote programs that strengthen resilience and academic motivation. Thus, improving educational and clinical performance., Competing Interests: Declaration of Competing Interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2023 Elsevier Ltd. All rights reserved.)

Objectives: Globally, adherence to COVID-19 health and safety protocols played a crucial role in preventing the spread of the virus. Thus, this study analyzed online news articles reporting adherence to COVID-19 health and safety protocols in the Philippines., Design: Manifest content analysis., Sample: News articles (n = 192) from three major online news portals in the Philippines., Measurement: Published online news articles were collected during the peak of the COVID-19 pandemic (March 2020 to March 2021). Bengtsson's content analysis approach was used to analyze the data. Member-checking and intercoder reliability validated the study's results., Results: Three main themes emerged: (a) adherence, (b) non-adherence, and (c) partial adherence. The subthemes were labeled who, what, when, where, and why. The same behavior, social distancing, was the most adhered to and non-adhered COVID-19 health protocol. This protocol has the highest occurrences in political protest, religious-related activities, and self-initiated quarantine. Leisure activities both showed non-adherence and partial adherence., Conclusions: Online news articles depicted Filipinos' adherence to health and safety protocols. Their adherence was primarily determined by one's group or community, social norms, and values. The government and its public health agencies should strengthen current efforts and continuously re-evaluate existing policies to modify ineffective and confusing safety health protocols., (© 2023 Wiley Periodicals LLC.)

Background: The COVID-19 pandemic is a global health crisis that affected nurses' professional values and competence., Aim: Our study examined the relationship between nurses' professional values and competence in Saudi Arabia during the COVID-19 pandemic., Methods: This study used a descriptive cross-sectional design with 748 nurses from Saudi Arabia. Two self-report instruments were used to collect data. Structural equation modelling was conducted to analyse the data., Findings: The emerging model showed acceptable model-fit indices. Two dimensions of nurse professional values significantly affected professional competence: professionalism and activism. Professionalism significantly affected the other four facets (e.g., caring, activism, trust, and justice) of nurse professional values. The dimension of caring had a strong direct effect on activism. Justice had a moderate direct impact on trust, while activism had a weak direct impact on trust. Professionalism and caring had strong indirect effects on professional competence by mediating the dimension of activism., Discussion: The study's findings highlight the need for strategies to evaluate and strengthen the various areas of professional values to foster professional competence among nurses. Moreover, nurse administrators should encourage nurses to participate in continuing nursing education programs or provide in-service educational training to promote professional values and competence., Conclusion: This study provides a structural model of the interaction between nurses' professional values and competence during the pandemic. Nurse administrators can leverage the presented model to develop policies and strategies to evaluate and strengthen nurses' professional values and competence., Competing Interests: The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (© 2023 Australian College of Nursing Ltd. Published by Elsevier Ltd.)

This study investigated the compliance and adherence of nursing staff (nurses, nursing assistants, and midwives) to standard precautions (SPs). A cross-sectional design while adhering to STROBE guidelines was used for this study. Nursing staff from a government tertiary hospital (n = 515) were recruited and completed the Compliance with Standard Precautions Scale (CSPS) and Factors Influencing Adherence to Standard Precautions Scale (FIASPS). Analysis of variance, Pearson's correlation, and linear regression analysis were used to analyze the data. The overall average compliance with the SPs of the nursing staff was suboptimal, and the disposal of sharps domain had the lowest compliance. Nurses were more compliant with sharps disposal, and nursing assistants with waste disposal. Contextual cues were the most influential factor influencing participants' adherence to SPs. All CSPS domains were significantly correlated with the Contextual cues factor of the FIASPS. Finally, service years and educational attainment were significant predictors of SPs adherence. The findings underscore the organization's critical responsibility for actively enforcing policies using monitoring systems and contextual cues in the workplace to ensure staff compliance and adherence with SPs., (© 2022 John Wiley & Sons Australia, Ltd.)

Aim: This study investigated the mediating role of resilience in the relationship between academic stress, COVID-19 anxiety, and quality of life (QoL) among Filipino nursing students during the COVID-19 pandemic., Background: The COVID-19 pandemic has impacted the QoL of nursing students who are experiencing mental health issues. The mediating role of resilience in mitigating the effects of academic stress and COVID-19 anxiety on nursing students' QoL remains understudied., Methods: This study employed a correlational cross-sectional design, with a convenience sample of 611 Filipino nursing students. Data were collected using the scales Connor and Davidson Resilience, Brunnsviken Brief Quality of Life, COVID-19 Anxiety, and Perception of Academic Stress and analyzed using Pearson's r, bivariate analysis, and multistage regression analyses., Results: Academic stress and COVID-19 anxiety negatively correlated with QoL and resilience. Resilience was positively associated with QoL and reduced the effect of academic stress on QoL, indicating that resilience is a crucial mediating variable between academic stress and QoL. Finally, resilience had a significant mediating influence on QoL, as evidenced by a reduction in the effect of COVID-19 anxiety on QoL among nursing students., Conclusions: Filipino nursing students' QoL was affected by academic stress and COVID-19-related anxiety. However, resilience mediated this impact, preserving QoL., Implications for Nursing and Health Policy: Nursing colleges and affiliated hospitals must collaborate to monitor academic stress and pandemic-related anxiety. Nursing students should be provided with programs such as seminars and team-building activities to enhance their resilience., (© 2022 International Council of Nurses.)

Background: In July 2022, human monkeypox (Mpox) was declared by the World Health Organization public health emergency of global concern. Assessing people's knowledge about Mpox will help the government and healthcare workers create policies to prevent the spread of the virus. To the best of my knowledge, this is the first study that assessed Filipinos' Mpox knowledge. Thus, this study investigated the Filipinos' Mpox knowledge and determined the demographic variables that predicted it., Methods: A descriptive cross-sectional design study participated by 557 Filipinos. This study used a 21-item Mpox knowledge survey questionnaire to collect data from July to September 2022. Logistic regression analysis was used to analyze the data., Results: Most participants (53.74%) were above 30 years old, females (68.87%), residing in Luzon (54.96%), college graduates (61.04%), Catholics (78.61%), and employed (68%). Social media, particularly Facebook (57.91%), is the common source of Mpox-related information (78.61%). Participants' age (>30 years old) is the only predictor of Mpox infection knowledge (aOR: 3.13; 95%CI: 1.25-7.87, p  = 0.015). They are three times more likely to be knowledgeable than those under 30., Conclusion: The findings highlight the importance of evidence-based strategies for increasing public knowledge and awareness. The government, healthcare workers, and the public should adopt proactive preventive measures against Mpox to prevent future pandemics., Competing Interests: The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (© 2023 Published by Elsevier Ltd.)

This study examined Filipino nursing students' use of household materials as low-cost simulators and how they aid in online return demonstrations. Summative content analysis guided this study. We collected uploaded YouTube videos (n = 14) depicting Filipino nursing students using low-cost simulators in their skills demonstration. We used Bengtsson's approach to content analysis to analyze the data. Four themes of low-cost simulators were identified: home and hardware, health and beauty, creative articles, and entertainment. The categories under home and hardware were tools, containers, furniture, and packaging. Health and beauty low-cost simulators were toiletries and medical supplies. Creative articles included fabrics, clothing accessories, and stationeries. Entertainment low-cost-simulators had toys and computer accessories. During the COVID-19 pandemic, our research uncovered home equipment employed as low-cost simulators to help nursing students' online simulation of skills demonstration. We recommend further investigation of whether students learned using low-cost simulators., Competing Interests: The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (© 2022 Organization for Associate Degree Nursing. Published by Elsevier Inc. All rights reserved.)

Objectives: Vaccine hesitancy is one of the top 10 threats to world health. The ongoing pandemic highlighted this health threat. The COVID-19 vaccine hesitancy remains underreported in the Philippines. Thus, this study aimed to describe and analyze the comments of Filipinos in TikTok videos about COVID-19 vaccine hesitancy., Design: Manifest content analysis., Sample: A total of 25 TikTok videos and their comments (n = 4564) were analyzed., Methods: We collected data between July 2021 and October 2021. Bengtsson's approach to content analysis was utilized to analyze the data. Data were validated using member-checking and intercoder reliability., Results: This study afforded three themes of COVID-19 vaccine hesitancy: (a) fear and mistrust (subthemes: influence of Dengvaxia vaccine, the influence of people who refuse to be vaccinated, lack of trust in the government, lack of trust in healthcare workers, doubts on vaccines' effectiveness), (b) misinformation and disinformation (subthemes: misbeliefs, insufficient knowledge), and (c) adamant attitudes (subthemes: unwillingness to be vaccinated, picky on vaccine brand)., Conclusion: Our study established Filipinos' diverse reasons for COVID-19 vaccine hesitancy. TikTok, as a social media platform, is used for COVID-19 vaccine discussions and the dissemination of misinformation. To prepare for the next pandemic or public health disaster, the government, HCWs, and the public must efficiently convey timely, accurate health information and dispel misinformation on social media platforms., (© 2022 Wiley Periodicals LLC.)

Background: Antibiotic resistance is one of the 21st century's most challenging clinical and public health issues. However, this health issue remains underreported in the Philippines., Aim: This study examined Filipinos' knowledge, attitude, and awareness regarding antibiotic use and resistance and the associated predictive variables of antibiotic resistance., Methods: A cross-sectional design and Strengthening the Reporting of Observational Studies in Epidemiology guidelines were used in this study. Convenience sampling of 3767 participants completed the Eurobarometer survey on antibiotic resistance from October 2021 to February 2022. χ 2 and regression analysis were used to analyze the data., Results: Most participants were familiar with the popular types of available antibiotics. Males and healthcare workers had a higher percentage of correct responses on antibiotic resistance knowledge. Participants had moderate to high knowledge levels of antibiotic resistance. Age, educational attainment, profession, antibiotic use in the previous year, and household members taking antibiotics were significant predictors of the level of knowledge of antibiotic resistance. There was a significant difference in participants' sex, age, and educational attainment in their attitudes toward acquisition, hygienic practices, and the role of health professionals in antibiotic resistance., Conclusion: Government agencies and policymakers should consider the identified predictors when establishing policies on antibiotic resistance. This will ensure that antibiotic use is safe and effective., (© 2022 Wiley Periodicals LLC.)

Aim: To examine the moderating effect of burnout on the relationship between nurses' competence, professional competence and professional values., Background: There is a preponderance of burnout studies of nurses before and during the COVID-19 pandemic. However, little is known about burnout's moderating influence on nurses' professionalism, competence and values during the ongoing pandemic., Methods: This study used a correlational, cross-sectional design and convenience sampling to recruit 809 Saudi nurses employed in four government hospitals. Four self-report instruments were used to collect data from August 2021 to March 2022. Spearman Rho, structural equation modelling and multi-group moderation analysis were used to analyse the data., Results: Most of the participants had high burnout. There was a moderate to high correlation between the dimensions of professional competence, nurse professional values, burnout and nurse competence. Both professional competence and nurse professional values significantly affected nurse competence. Nurse professional values also had a direct effect on professional competence. Professional competence and nurse professional values on nurse competence may vary among those with low, moderate and high levels of burnout, suggesting the moderating effect of burnout., Conclusions: The positive impacts of nurse professional values and professional competence on nursing competence were validated in this study, as was the evidence of burnout's moderating effect on the studied connections. To avoid burnout, it is necessary to increase organizational knowledge and support for nurses, their working conditions and the environment through strategies that promote well-being and empowerment., Implications for Nursing Management: Nurse managers can implement policies to help nurses minimize burnout and improve their professional values and competence. Management policies may be considered include increased staffing, opportunities to improve technical abilities through education and vocational training programs, and increased diversity of job assignments., (© 2022 John Wiley & Sons Ltd.)

Background: Students' decision to pursue a nursing career is influenced by internal (e.g., innate desire, personal experiences) and external variables (e.g., parental influence, social support). However, little is known about how parental authority mediates nursing students' career decision-making self-efficacy, decision-making ambiguity, and nursing as a career choice., Purpose: This study examined the influence of parental authority on nursing students' decision to pursue nursing and its mediating effect on the association between career choice, career decision ambiguity, and career decision-making self-efficacy., Methods: A cross-sectional study that used total enumeration sampling. Four self-report survey instruments were utilized to collect data from nursing students (n = 378) of a state-run university in Saudi Arabia. The data were analyzed using Pearson's correlation coefficient, covariance-based structural equation model, and path analysis., Results: The emerging model showed acceptable model fit indices. The path analysis indicated that parental authority mediated the relationship between career decision-making self-efficacy and nursing career choice. Career decision-making self-efficacy positively and indirectly affected nursing career choice through the mediation of parental authority. Career decision ambiguity tolerance did not directly influence parental authority, but it had a positive, indirect effect through the mediation of career decision-making self-efficacy of nursing students., Conclusion: The strong and direct correlation between career decision-making self-efficacy, career decision ambiguity tolerance, and nursing career choice demonstrated in our study indicates that parental authority strongly influences nursing students' career choices. Our study concludes that parental authority over their children is highly predictive of their career choices., Competing Interests: Declaration of competing interest The authors declare that there are no conflicts of interest., (Copyright © 2022 Elsevier Inc. All rights reserved.)

Aims: To investigate graduating nursing students' nursing and professional competencies and the predictors of their competencies., Background: Across Asian countries, there is a paucity of literature that explores graduating nursing students' competency and professional competence during the ongoing COVID-19 pandemic., Design: Descriptive, cross-sectional, and predictive approaches., Method: Convenience sampling was used among graduating nursing students from the six Asian countries (n = 375). The STROBE guidelines for cross-sectional studies were used. Two self-report instruments were utilized to collect data. We conducted multiple linear regression analyses to assess the predictors of nursing competency and professional competence domains., Results: Country of residence and general point average (GPA) showed statistically significant multivariate effects. Value-based nursing care and critical thinking and reasoning domains recorded the highest in professional competence and competency inventory for nursing students, respectively. Country of residence, GPA, and preferred nursing major were significant predictors of graduating nursing students' nursing competency and professional competence domains., Conclusion: Our study's findings revealed a high level of diversity among nursing students regarding ethical care obligations, caring pedagogies, and lifelong learning, all of which may be ascribed to their distinct culture, background, and belief systems., (Copyright © 2022 Elsevier Ltd. All rights reserved.)

Background: It is crucial to evaluate student academic motivation and self-directed learning (SDL) readiness while teaching online or flexibly. During the coronavirus disease 2019 pandemic, there were few investigations on the link between academic motivation and SDL readiness., Aim: This study investigated the connection between academic motivation and SDL readiness and the three academic motivation domains' predictive features., Methods: This cross-sectional study used convenience sampling to recruit 1187 nursing students from four nursing colleges in three countries. We utilized the Academic Motivation Scale College Version and Self-directed Learning Readiness Scale for Nurse Education to collect data. Descriptive and inferential statistics were employed to analyze the data., Results: Extrinsic motivation received the highest mean. Most nursing students exhibited SDL readiness, whereas "desire for learning" was rated the highest dimension of SDL readiness. We found significant differences in nursing students' intrinsic and extrinsic motivation and amotivation between the three countries. Finally, country, gender, and intrinsic motivation were significant predictors of the nursing students' SDL readiness., Conclusion: Among Filipino, Saudi, and Thai nursing students, their SDL readiness is influenced by the intrinsic motivation domain. Therefore, nursing students with higher levels of intrinsic motivation are proactive learners for SDL., (© 2022 Wiley Periodicals LLC.)

Objectives: This study examined Filipinos' health information-seeking behaviors, specifically their information engagement and apprehension of getting the COVID-19 vaccine, the reasons for vaccination, and how these factors influenced their decision to get vaccinated., Design: Quantitative, cross-sectional, and predictive approaches., Sample: This study conducted a national online survey using convenience sampling (n = 2709)., Measurement: The Health Information Orientation Scale (HIOS) and Statista.com's "reasons for not getting a COVID-19 vaccination" were used to collect data. Demographic characteristics that predict information engagement and apprehension were identified using multivariate linear regression analysis., Results: Responses to information engagement and apprehension revealed "often true" and "sometimes true," respectively. The majority of participants intended to receive the COVID-19 vaccine. "Concerned about the vaccine's safety" is the most common reason for not getting vaccinated. Female gender, college graduate, employed, and using social media to obtain COVID-19 vaccine information were all significant predictors of information engagement and apprehension. Information engagement and apprehension were predicted by age and religion, respectively., Conclusions: Policymakers should consider how people seek information regarding the COVID-19 vaccine and why some people refuse to get vaccinated. Additionally, public health nurses should educate the public about the safety of COVID-19 vaccines., (© 2021 Wiley Periodicals LLC.)

Objectives: Many women use over-the-counter (OTC) medicines, particularly during pregnancy. Therefore, this study investigated the perceived risks of using OTC medicines among pregnant Saudi mothers., Methods: With a cross-sectional design and purposive sampling, the 28-item Drug Use Health Belief Scale was used to collect data from pregnant Saudi mothers (n = 366) in a general tertiary hospital. The data were analyzed with descriptive and inferential statistics. After normality testing, the percentages, mean scores, and standard deviations were used to examine the demographic data. One-way ANOVA was used to identify the relationships between perceived risks on the Health Belief Scale and the participants' sociodemographic profile variables. Post-hoc tests were used to identify differences in the independent variables among groups. The statistical significance threshold was set at p ≤ 0.05., Results: Across the five domains of the Health Belief Scale, the perceived susceptibility domain had the highest rank (0.36). Significant differences were observed between the mean scores of pregnant Saudi mothers' perceptions of susceptibility and the benefits of using OTC medications (p = 0.05), perceptions of susceptibility (p < 0.001), and benefits while using OTC medications (p = 0.018) than those who did not use OTC medications. However, no significant differences were observed in the degree of perceived severity, barriers, and self-efficacy in mothers using OTC medications (p > 0.05)., Conclusion: Notable differences were found in pregnant women's perceptions of the risks of using OTC medications. Greater awareness of the risks of OTC medication use during pregnancy is required. To ensure mothers' safety, a collaboration between prenatal multidisciplinary team of professionals (e.g., doctors, nurses, midwives) in community and hospital settings should be prioritized., (© 2022 [The Author/The Authors].)

Background: Over the past year, healthcare workers constantly report their COVID-19 anxiety. However, this concept remained understudied among nursing students (NSs)., Aim: This study investigated the difference between NSs' three types of anxiety and their profile variables during the COVID-19 pandemic., Methods: This study used a cross-sectional, descriptive-correlational design. Three instruments were used: COVID-19 anxiety scale (CAS), COVID-19 anxiety syndrome scale (COVID-19ASS), and short health anxiety inventory (SHAI) to collect data from 484 Saudi NSs. We applied the Mann-Whitney U test and linear regression to analyze the data., Results: Across the three instruments; CAS, Item 1 "I feel bad when thinking about COVID-19"; COVID-19ASS, Item 11 "I have imagined what could happen to my family members if they contracted COVID-19"; and SHAI, Item 17 "A serious illness could ruin many aspects of my life" yielded the highest means. COVID-19ASS showed a significant difference for the profiles "known positive" (p = 0.05) and "action taken after with testing" (p = 0.05). NS, who knew someone with COVID-19, was the only predictor of CAS., Conclusion: Our study concludes NSs experience anxiety symptoms. Anxiety is specific to COVID-19 or a set of similar anxiety symptoms. Further research is needed to explore the anxiety state of NSs during the pandemic., (© 2021 Wiley Periodicals LLC.)

Objectives: Studies on quality of life (QoL) and academic resilience among nursing students during the Coronavirus disease (COVID-19) pandemic remain underreported. This study investigated the relationship between nursing students' QoL and academic resilience and their predictors during the COVID-19 pandemic., Methods: A descriptive survey, cross-sectional study that used two self-reported questionnaire scales to evaluate the QoL and academic resilience of Filipino nursing students (n=924). Chi-squared test and multiple regression were used to analyze the data., Results: There was no significant association between the QoL and academic resilience to participants' profile variables. Gender and year level of nursing students were significant predictors of QoL and academic resilience., Conclusions: Our study concludes that a better understanding of the QoL and academic resilience, which are two distinct concepts critical in developing a student's mental well-being, will help stakeholders in nursing education establish effective psychoeducation programs for nursing students., (© 2021 Walter de Gruyter GmbH, Berlin/Boston.)

Objective: Across the Middle Eastern countries, there is a lack of studies exploring the connection between the quality of life (QoL) and academic resilience of nursing students. This study determines the association between nursing students' profile variables and their QoL and academic resilience (AR)., Methods: A descriptive cross-sectional design with structural equation modeling (SEM) was adopted. This study was conducted at the College of Nursing at the University of Ha'il, KSA. Survey questionnaires using the 12-item Brunnsviken Brief Quality of Life Scale (BBQ) and 30-item Academic Resilience Scale (ARS-30) were utilised to collect data from nursing students (n = 384). SEM via latent variable analysis ( lavaan ) software version 0.6-7 was used for statistical derivation and analysis., Results: SEM revealed no correlation with QoL and AR when compared using the participants' profile variables (gender, year level, and enrolled units). There was a correlation between the grade point average (GPA) and QoL. However, no association was found between QoL and AR., Conclusion: GPA exhibited a positive correlation with QoL; thus, nursing students with higher GPA have a more stable and desirable QoL. Additionally, our findings illustrate the individuality of nursing students despite their shared characteristics., (© 2021 The Authors.)

Purpose: This study investigated the relationship between nursing students' profile variables and their state of mental well-being and resilience during the coronavirus disease-19 (COVID-19) pandemic and how this impacts their understanding of holistic nursing care provision. Design: This study used a cross-sectional design and total enumeration sample ( n  = 439) from all enrolled nursing students in the College of Nursing of a state-run university. Method: The 10-item Connor-Davidson Resilience Scale (CD-RISC) and 14-item Warwick-Edinburgh Mental Well-Being Scale (WEMWBS) were used to collect data from the participants. A correlational analysis was employed to determine the relationship between the responses of the participants to their profile variables. Findings: There were no significant differences in age, gender, and year level in the 10-item CD-RISC and WEMWBS. Regarding the WEMWBS, the mean total score of those with 61-100% of the allowed units was significantly higher than those with 31-60%. Finally, the CD-RISC scores revealed that participants with a general point average (GPA) of A were significantly higher than those with a GPA of B+ or B. Conclusion: Academically performing students (those with a GPA of B and above) are more resilient. In addition, there is an existing linear relationship between high mental well-being and the ability to pursue higher academic loads.

Background: In middle eastern countries, most nursing colleges use simulation-based learning activities. However, Saudi nursing students' correlators and predictors for simulation learning have been underreported., Aim: This study investigated the variables that correlate to and predict Saudi nursing students' simulation learning competencies., Methods: A descriptive cross-sectional design guided this study's understanding of simulation learning among nursing students (n = 461). We used three National League of Nursing instruments to collect data: the 13-item student satisfaction and self-confidence in learning scale (SCLS), 20-item simulation design scale (SDS), and 16-item educational practices questionnaire (EPQ). We applied analysis of variance, t tests, χ 2 tests, and linear regression to analyze the data., Results: The SCLS and EPQ revealed significant differences in the participants' year level, gender, fidelity of simulation experience, number of nursing courses with simulation, and grade point average (GPA). Only GPA was insignificant in SDS. The number of nursing courses with simulations and GPA were significant predictors of the three instruments. Finally, year level and gender were important predictors of SDS and SCLS, respectively., Conclusion: Our findings explain Saudi students' experiences of simulations in nursing education. Simulation is an important pedagogical approach that enhances students' achievements when implemented in nursing schools., (© 2021 Wiley Periodicals LLC.)

Objectives: This study investigated the quality of life (QoL) of nursing internship students (NISs) and the predictive variables for the QoL of NISs during the COVID-19 pandemic. The correlates of QoL of NISs with their gender, age, prior nursing experience, and grade point average (GPA) from the previous semester are also assessed., Methods: This study used a quantitative cross-sectional design through an electronic survey form for the collection of required data. The 22-item Quality of Life Evaluation Scale (QOLES) was adopted as the survey instrument. A total of 283 NISs from five public universities in KSA completed the survey., Results: The students' age, gender, and nursing-related experience prior to their internship were all found to be significantly associated with the overall QOLES score ( p values of 0.001, 0.001, and 0.01, respectively). The NISs GPA was found to be marginally significant ( p  = 0.08). A significant difference was identified in the overall QOLES score based on age ( p  = 0.02), gender ( p  = 0.02), and GPA ( p  = <0.001). Finally, as estimated by the regression analysis, only age ( p  = 0.002) was found to be a significant predictor of NISs' QoL., Conclusion: In this study, the QoL of Saudi NISs was positively correlated with their age and gender. Male NISs had greater QoL than females, while a high QoL was observed among students with high GPAs before the internship year. Only the age of the NISs was found to be a reliable predictor of QoL., (© 2021 The Authors.)

Background: The COVID-19 pandemic caused an unprecedented negative impact on the usual way of life. The fight against this fatal virus demands the united force of healthcare workers, including nurse interns (NIs). Therefore, being unprepared for a crisis of this magnitude which never happened in a century, nurses and NIs experience stress, trauma, and mental health issues that affect their quality of life (QoL)., Objectives: This study inquired the demographic of the NIs, the responses of the participants to the domains of Quality of Life Evaluation Scale (QOLES), and the relationship between the participants' responses to the scale to each of their demographic profiles., Methods: This study used a quantitative cross-sectional design through an electronic survey form in the collection of data. Utilizing total enumeration as sampling technique, 152 NIs in Saudi Arabia completed the survey., Results: Across the 22-item questionnaire, the NIs still feel safe being in the hospital, clinic, or other healthcare facilities with a mean of 3.32; while item 8, which is having abundant energy, had the lowest mean of 1.91. The overall mean is 2.61, interpreted as 'important,' signifying that the participants 'agree to some extent.', Conclusion: The QoL of the NIs focused more on their psychological wellbeing and social relationships while the environmental and physical domains had lesser emphasis. In terms of enhancing specificity, comprehensiveness, and generalizability of future studies in QoL, a larger sample and more rigorous design is recommended., Competing Interests: The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (© 2021 Published by Elsevier Ltd.)

Objectives: This study determined the perceived professional values of nursing students, which are potentially correlated to their individual profiles., Methods: This study utilized a cross-sectional design using the Nurse Professional Values Scale-Revised (NPVS-R) to determine nursing students' innate professional values. This study recruited 201 nursing students using a total enumeration sampling from Ha'il region, KSA., Results: In the 26-item NPVS-R scale, item 1 was correlated to academic status at 0.01; item 3 was significantly correlated to gender at 0.01 and fluency in English at 0.01; item 4 was positively correlated to year level and fluency in English language at 0.00 and 0.0, respectively. Additionally, item 5 was found to be correlated to gender at 0.01; item 12 was correlated to gender at 0.01, year level (0.00), and fluency in English (0.01) and item 21 was correlated to gender and year level at 0.00 and 0.01, respectively. Finally, items 7, 22, 23, 24, 25, and 26 were significantly correlated with year level. The items with the highest correlations to the social determinants of the participants belonged to the values, justice and caring. Since nursing is a caring profession, these findings acknowledge that the values embodied by nursing students are critical. This reaffirms that nurses provide care with responsibility and accountability for its outcomes., Conclusion: In this study, the participants recognized the protection and safety of public health as the most significant professional value. Similarly, patient confidentiality and the active involvement of nurses in professional organizations was highly valued., (© 2020 The Authors.)