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Abstract Objectives This systematic review aimed to synthesize evidence on the ethical dilemma’s nurses encounter in end-of-life care and effective palliative care practices. The objectives were to understand key ethical issues, evaluate communication and decision-making strategies, and identify approaches to support nurses and patients. Methods A comprehensive search of major databases was conducted according to the PRISMA guidelines. Studies directly relating to nursing ethics, challenges in end-of-life decision-making, and palliative care practices were included. The risk of bias was assessed using ROBVIS-II. Data on ethical issues, palliative interventions, and outcomes was extracted and analyzed thematically. Results 22 studies met the inclusion criteria. Key themes that emerged were: (1) Effective communication and involving patients in decision-making are essential but complex. (2) Nurses face dilemmas around balancing autonomy, beneficence and relational issues. (3) Integrating palliative care principles enhances symptom management and aligns care with patient values. (4) Education and organizational support are needed to equip nurses with skills and coping strategies. Conclusion Navigating end-of-life care requires addressing interconnected ethical, communication and support needs. While studies provided insights, further research is required on cultural competence training, standardized education programs and longitudinal evaluations.

Objectives: The objective of the study was to explore the impact of auditory stimulation protocol on auditory response in cerebrovascular stroke (CVS) patients. Materials and Methods: A pre–posttest nonequivalent control group quasi-experimental study was conducted at Al Mainal Hospital at Al Kars Einy Hospital, Cairo University, among 60 CVS patients, and the sample was randomly assigned through a coin to allocate subjects to study or control group (30 for each group). Auditory stimulation techniques were applied three times per week for the study group for two consecutive weeks. Patients in the control group received only routine hospital care during the study period. The Glasgow Coma Scale (GCS) score for assessing the neurological function and level of arousal and the auditory subscale score of Western Neuro Sensory Stimulation Profile (WNSSP) for assessing auditory response were recorded and compared between the two groups before and after the intervention. Results: There were statistically significant differences between the study group and the control group regarding third reading of GCS score (11.5 ± 0.3 vs. 10.6 ± 0.9, t = 4.676, P = 0.000). The scores of all auditory subscales of WNSSP in the study groups increased after implementing the auditory stimulation protocol (P < 0.05). Conclusion: Utilizing the auditory stimulation protocol by nurse proves to be an effective method for enhancing hearing responses in individuals with CVS.

Abstract The practice of routine gastric residual aspiration in preterm infants remains controversial, with conflicting evidence regarding its impact on necrotizing enterocolitis (NEC). As front-line caregivers, nurses play a vital role in gastric aspiration procedures and must be informed by evidence. This quasi-experimental nursing study aimed to assess whether gastric aspiration is clinically relevant in reducing the risk of NEC in preterm infants. A total of 250 preterm infants from two NICUs in Egypt were allocated to the gastric aspiration (n = 125) and non-aspiration (n = 125) groups. Feeding practices, gastric residuals, and incidence/severity of NEC were compared between groups according to modified Bell’s criteria. Risk factors were analyzed using multivariate regression. There were no significant baseline differences between the groups. The gastric residual attributes and feeding outcomes did not differ substantially from aspiration. The overall incidence of NEC was 14–15%, with no significant differences in the odds of onset or progression of NEC by stage between the groups. Lower gestational age and birth weight emerged as stronger predictors of NEC. Routine gastric aspiration does not appear to directly prevent or reduce the severity of NEC in this population. Although gastric residuals retain clinical importance, study findings question assumptions that aspiration protects against NEC and informs nursing practice. Evidence-based feeding protocols must continually evolve through ongoing research on modifiable risk factors for this devastating intestinal disease in preterm infants.

Objective: Rheumatoid arthritis (RA) requires comprehensive management. Structured nursing protocols may enhance outcomes, but evidence is limited. This study evaluated the effect of a structured nursing protocol on RA outcomes. Materials and Methods: In this one-group pre-post study, 30 Egyptian RA patients completed assessments before and after a 12-week nursing protocol comprising education, psychosocial support, and self-management promotion. Assessments included clinical evaluation of joint counts, erythrocyte sedimentation rate (ESR), and C-reactive protein (CRP) and patient-reported Arthritis Self-Efficacy Scale (ASES), Health Assessment Questionnaire (HAQ), Visual Analog Scale (VAS) for pain, and Hospital Anxiety and Depression Scale (HADS). Results: The study demonstrated significant improvements in both clinical- and patient-reported outcomes. Joint count decreased from 18.4 ± 4.2 to 14.2 ± 3.8 (P < 0.001), ESR from 30.1 ± 6.8 mm/h to 25.5 ± 6.8 mm/h (P < 0.01), and CRP levels from 15.2 ± 3.6 mg/L to 11.8 ± 2.9 mg/L (P < 0.01) postintervention. Patient-reported outcomes showed a marked increase in ASES score from 140 ± 25 to 170 ± 30 (P < 0.001) and reductions in HAQ from 1.6 ± 0.4 to 1.3 ± 0.3 (P < 0.01), VAS pain score from 7.8 ± 1.7 to 6.2 ± 1.2 (P < 0.001), and HADS anxiety and depression scores from 11 ± 3 to 8 ± 2 (P < 0.05) and 10 ± 2 to 7 ± 1 (P < 0.05), respectively. Conclusion: A structured nursing protocol significantly improved clinical disease activity, physical functioning, pain, self-efficacy, and emotional well-being in RA patients. A multifaceted nursing intervention appears beneficial for optimizing RA outcomes.