Are nurses and patients willing to work with service robots in healthcare? A mixed-methods study.

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

How Decent Work Influences Internal Whistleblowing Intentions in Nurses: The Parallel Mediating Roles of Felt Obligation and Organisational Identification-A Cross-Sectional Survey.

INTRODUCTION: Fostering nurses' intentions to blow the whistle internally is a salient issue in healthcare. However, there are debates on the antecedents of these intentions, and the explanation of how these antecedents influence such intentions is missing in the nursing literature. AIM: Based on the social exchange theory and the social identity theory, this study aimed to unveil how decent work influences nurses' internal whistleblowing intentions, specifically through the parallel mediating roles of felt obligation and organisational identification. METHODS: A cross-sectional survey was conducted with a convenience sample of 268 clinical nurses from three tertiary public hospitals in Mansoura, Egypt. Data were collected between June and November 2023 using the Decent Work Scale, the Felt Obligation Scale, the Organisational Identification Scale and the Internal Whistleblowing Intentions Scale. Study hypotheses were tested using structural equation modelling. RESULTS: Decent work significantly influenced nurses' internal whistleblowing intentions. Felt obligation and organisational identification partially mediated the positive relationship between decent work and internal whistleblowing intentions. CONCLUSION: Decent work is a significant predictor in nurturing felt obligation and organisational identification, leading to an increased willingness among nurses to engage in internal whistleblowing. IMPACT: This study offers valuable insights into how hospital administrators can leverage internal whistleblowing intentions among nurses. It showed that securing decent work conditions, fostering felt obligation and organisational identification contribute to an increased willingness to blow the whistle. PATIENT OR PUBLIC CONTRIBUTION: No patient or public contribution.

Sentiment of Nurses Towards Artificial Intelligence and Resistance to Change in Healthcare Organisations: A Mixed-Method Study.

BACKGROUND: Research identified preliminary evidence that artificial intelligence (AI) has emerged as a transformative force in healthcare, revolutionising various aspects of healthcare delivery, from diagnostics to treatment planning. However, integrating AI into healthcare systems in Egypt is challenging, particularly concerning healthcare professionals' acceptance and adoption of these technologies. This mixed-method study aimed to explore the sentiment of nurses at different organisational levels towards AI and resistance to change in healthcare organisations. METHODS: A mixed-method design was employed, with quantitative data collected through a survey of 500 nurses using the general attitudes towards AI and resistance to change scale and qualitative data from semi-structured interviews with 17 nurses. Quantitative data were analysed using descriptive and inferential statistics, while qualitative data were analysed thematically. RESULTS: The survey demonstrated that positive attitudes were inversely correlated with resistance behaviour and resistance to change. Additionally, perceptions of AI's usefulness, ease of use and value were strongly and positively correlated with positive attitudes and negatively correlated with negative attitudes. Moreover, the influence of colleagues' opinions, self-efficacy for change and organisational support showed significant positive correlations with positive attitudes towards AI and negative correlations with negative attitudes. Qualitatively, nurses cited obstacles such as lack of familiarity with AI technologies, biases affecting decision-making, technological challenges, inadequate training and fear of technology replacing human interaction. Readiness for AI integration was associated with the necessity of training and the timing of AI use. CONCLUSION: Nurses demonstrated varied understanding of AI's applications and benefits. Some acknowledged its potential for efficiency and time-saving, while others highlighted a need for up-to-date knowledge. PATIENT OR PUBLIC CONTRIBUTION: No patient or public contribution.

Advancing trauma studies: A narrative literature review embracing a holistic perspective and critiquing traditional models.

Background: Trauma is commonly understood as a psychological and emotional response to distressing events. The subjective nature of trauma experiences has led to ongoing debates about the best theoretical frameworks for understanding and addressing trauma. This review aims to comprehensively critique traditional biomedical and psychological models and advocates for more inclusive and culturally sensitive frameworks. Methods: A narrative literature review was conducted, synthesizing data from 96 peer-reviewed journal articles, books, and authoritative reports from databases such as PubMed, PsycINFO, and Google Scholar. The review focused on studies related to trauma, post-traumatic stress disorder (PTSD), complex trauma, and related disorders, emphasizing both individual and socio-cultural aspects. Results: The review identifies several key criticisms of trauma models. For biological models, critiques include the oversimplification of trauma experiences, insufficient developmental considerations, failure to capture diverse trauma responses, limited cultural sensitivity, and inadequacy of the categorical approach. For psychological models, criticisms encompass an overemphasis on internal processes, neglect of developmental impacts, limited focus on symptom diversity, challenges in addressing socio-cultural contexts, and incomplete integration of emotional and relational aspects. These findings underscore the need for more comprehensive, culturally sensitive, and developmentally informed trauma frameworks. Conclusion: The findings emphasize the importance of adopting a holistic perspective in trauma research and treatment. By integrating individual, interpersonal, and socio-cultural dimensions, future research and interventions can better support trauma survivors. This approach necessitates ongoing interdisciplinary collaboration and the inclusion of diverse voices, including those of trauma survivors, to refine current methodologies and enhance therapeutic outcomes.

Feasibility and Preliminary Evaluation of Theory-Based Training Program on Daily Living Skills Among Children With Autism Spectrum Disorder: Findings From Rural Regions in Egypt.

BACKGROUND: One of the most crucial objectives in the education and treatment of young children with autism spectrum disorder (ASD) is independence in daily living skills (DLS). Therefore, as a child with ASD condition grows, measures of everyday functioning including adaptive behaviors should be more regularly monitored and regulated. AIM: The primary aim of this study was to evaluate the feasibility of a developed theory-based training program and its preliminary effectiveness on the acquisition of DLS among school-age children with ASD. METHODS: A preliminary experimental research design (pre- and post-evaluation) was conducted from the beginning of May to the end of July 2023 on 31 children with ASD. The socio-economic status scale, Vineland Adaptive Behavior Scale, and Gilliam Autism Rating Scale were administered before and after a theory-based DLS training program. RESULTS: There was a significant difference in the DLS and motor functioning before and after the implementation of the training program (p < .001 and p = .021, respectively). In addition, there was a significant difference in the total score of autistic severity before and after the implementation of the training program (p < .001). CONCLUSION: The promising outcomes of the study indicate the need for further testing and expansion of this intervention. These findings contribute to the growing body of evidence highlighting the significance of DLS training program in the comprehensive treatment approach for children with ASD. Consequently, proposing DLS training programs as a cost-effective and efficient nursing intervention is warranted.

Sparking nurses' creativity: the roles of ambidextrous leadership and psychological safety.

BACKGROUND: The leadership practices of nurse managers significantly impact the creativity of staff nurses; however, the effects of ambidextrous leadership on nurses' creativity are not yet clear. Additionally, the underlying mechanism of this relationship remains to be identified. AIM: The study aimed to examine the effect of ambidextrous leadership on nurses' creativity, directly and indirectly through psychological safety. METHODS: In this cross-sectional study, data were collected from October 2023 to January 2024 involving 241 nurses working at three hospitals in Port Said, Egypt. The Ambidextrous Leadership Scale, Psychological Safety Scale, and the Individual Creativity Scale were employed. Descriptive analysis, correlation analysis, and structural equation modeling were conducted. RESULTS: Nurse managers' ambidextrous leadership was positively associated with nurses' creativity. Psychological safety fully mediated the association between ambidextrous leadership and nurses' creativity. CONCLUSION: The study suggests that enhancing the ambidexterity of nurse leaders can foster a sense of psychological safety, which, in effect, contributes to increased creativity among nurses. IMPLICATION FOR NURSING POLICYMAKING: There is a need for healthcare policies and strategies that are supportive of the implementation of ambidextrous leadership practices and promote psychological safety among nurses.

Impact of moral resilience and interprofessional collaboration on nurses' ethical competence.

BACKGROUND: Home care nurses are central in providing holistic and compassionate care to patients in home-based palliative care. Ethical caring competency is essential for home care to sustain nurses' integrity in the face of moral adversity. Interprofessional collaboration is vital for ensuring ethical decision-making and providing patient-centered care in home-based palliative care settings. AIM: This study explored the predictive roles of interprofessional collaboration and moral resilience on ethical caring competency among home care nurses in home-based palliative care. METHODS: A cross-sectional survey of 400 nurses was conducted from October to December 2023, utilizing standardized scales to measure interprofessional collaboration, moral resilience, and ethical caring competency. A convenience sample of 400 home care nurses was also included in this study. Correlation and linear regression analysis were used to clarify the associative and predictive findings. ETHICAL CONSIDERATIONS: Ethical approval from the ethics committee, institutional permission, and informed consent from the participants were obtained for data collection. RESULTS: Correlation analysis showed significant positive correlations between the ethical caring competency, interprofessional collaboration, and moral resilience constructs, with coefficients ranging from 0.482 to 0.967. Linear regression revealed that management of collaborative systems and total moral resilience significantly predict ethical caring competency, explaining 14.6% and 36.6% of its variance, respectively. Other variables, such as the effects of collaboration and communication, did not significantly influence ethical caring competency. CONCLUSION: The study highlights the significant impact of interprofessional collaboration, particularly the management of collaborative systems and moral resilience, on enhancing ethical caring competency among nurses. IMPLICATIONS: Enhancing interprofessional collaboration and moral resilience through targeted strategies in nursing practice and education can significantly improve ethical caring competencies. These efforts are essential for delivering high-quality, patient-centered care and for fostering a healthcare environment that respects the ethical principles guiding nursing practice.

Linking ethical leadership to nurses' internal whistleblowing through psychological safety.

Background: Cultivating internal whistleblowing among nurses is of paramount importance to nurse leaders. Yet, the literature on how nurse leaders can foster this phenomenon among nurses is limited. Additionally, the underlying mechanisms linking leadership behaviors to internal whistleblowing intentions remain underexplored.Aim: This study aimed to examine how ethical leadership is linked to internal whistleblowing intentions among nurses through the mediating effect of psychological safety.Research design: A multicenter cross-sectional research design was used for this study.Participants and research context: This study involved 201 nurses working in three tertiary governmental hospitals across three cities in Egypt. Data were collected between October and December 2023, using an introductory information form, the Ethical Leadership Scale, the Psychological Safety Scale, and the Internal Whistleblowing Intentions Scale. Structural equation modeling was used to evaluate study hypotheses.Ethical consideration: Research Ethics Committee of Faculty of Nursing, Port Said University, Egypt approved the study (reference number: NUR (6/8/2023)(28)), and each participant signed the informed consent form before participation in the study.Results: Ethical leadership was positively linked to nurses' psychological safety and internal whistleblowing intentions. Psychological safety mediated the link between ethical leadership and nurses' internal whistleblowing intentions.Conclusion: Our study suggests that nurse leaders can foster nurses' intentions to blow the whistle internally by adopting ethical leadership behaviors and enhancing psychological safety among nurses.

Family-centred care as a mediator in the relationship between parental nurse support and parental stress in neonatal intensive care units.

BACKGROUND: Within the NICU, there is a delicate equilibrium between providing assistance to parents by nurses and prioritising family-centred care (FCC). The FCC assumes the role of a mediator, effectively conveying compassion. The intricate dynamics between FCC, parental nurse support, and parental stress in neonatal intensive care units (NICUs) necessitate comprehensive investigation. OBJECTIVE: This study examines the mediating effect of FCC on the relationship between parental nurse support and parental stress in NICUs. METHODS: This cross-sectional observational study used convenience sampling to select 223 parents (202 mothers) from Mansoura City hospitals in Egypt. Data were collected using the Nurse Parent Support Tool (NPST), Family-Centered Care Self-Assessment Tool (FCCS-NICU), and the Parental Stressor Scale: NICU (PSS: NICU). Mediation analysis was used to examine the relationships between variables. RESULTS: Nurse support was positively associated with FCC (ß = 0.81, p < 0.001) and negatively related to parental stress (ß=-1.156, p < 0.001). FCC was found to reduce parental stress (ß=-0.18, p < 0.001). Mediation analysis confirmed that FCC partially mediated the relationship between nurse support and parental stress (indirect effect ß = 0.145, 95% CI: 0.055-1.007). CONCLUSIONS: This study highlights a significant association in the mediating role of FCC between nurse support and parental stress. Strengthening FCC practices can be an effective strategy for nurses to support parents and alleviate their stress in NICU settings. IMPLICATIONS TO PRACTICE: NICUs should implement FCC-oriented training for nurses, foster a culture that supports FCC principles, and develop policies to establish FCC as a cornerstone of neonatal care.

Does internet addiction affect the level of emotional intelligence among nursing students? A cross-sectional study.

AIM: To examine the effect of internet addiction on emotional intelligence among nursing students. Internet addiction, especially among nursing students, is an ongoing and urgent issue globally. Despite studies acknowledging its negative effects, the specific impact on the emotional intelligence of college students is not completely explored and needs more investigation. DESIGN: A correlational cross-sectional descriptive study. METHODS: Participants included 180 nursing students from Mansoura University, Egypt. They completed the Socio-demographic sheet, Internet Addiction Test, and Schutte Self-Report Emotional Intelligence. Descriptive statistics, Pearson correlation, and regression analysis were conducted to analyze the data. RESULTS: Nursing students experience a moderate level of internet addiction and a neutral level of emotional intelligence. A significant negative relationship was established between internet addiction among students and their emotional intelligence (r = - 0.53, p < 0.001) and its four facets: perception of emotion, managing own emotions, managing others' emotions, and utilization of emotion. Regression analysis showed that internet addiction had a negative effect on emotional intelligence among nursing students (ß = - 0.553, p < 0.001) and explained 30.5% of the variance of emotional intelligence among nursing students. CONCLUSIONS: The study findings suggest that internet addiction negatively impacts the emotional intelligence of nursing students, which is crucial for effective interpersonal relations and professional competence in nursing. IMPLICATIONS: The study underscores the need for educational programs to raise awareness about the hazards of excessive internet use and to promote activities that mitigate internet addiction.

Nurturing Success: E-Learning readiness and academic self-efficacy in nursing students.

BACKGROUND: As nursing education embraces e-learning as a vital component of its pedagogical approach, understanding the interplay between students' readiness for E-learning and their academic self-efficacy becomes imperative in nurturing successful learning outcomes amidst evolving educational paradigms. PURPOSE: This study aimed to explore the relationship between e-learning readiness, academic self-efficacy, and the academic achievement of nursing students within the dynamic educational environment. DESIGN: This study employed a cross-sectional design. METHODS: A total of 208 nursing students were recruited through convenience sampling at the end of the second semester in 2022. The evaluation included the utilization of Grade Point Average, the Online Learning Readiness Scale, and the Academic Self-Efficacy Scale. FINDINGS: Previous research has indicated a significant positive correlation between academic achievement and readiness for e-learning, suggesting that higher levels of readiness for e-learning among nursing students lead to improved academic achievement (p ≤ 0.001). Additionally, the findings of the current study revealed a notable positive correlation between academic achievement and academic self-efficacy (p ≤ 0.001). CONCLUSION: This study provides valuable insights into the critical role of academic self-efficacy and e-learning readiness in enhancing academic achievement among nursing students.

Effectiveness of Acceptance and Commitment Therapy on Psychotic Severity Among Inpatients With Primary Psychoses: A Randomized Controlled Trial.

This study investigated the effectiveness of acceptance and commitment therapy (ACT) compared to treatment as usual in managing psychotic symptoms, emotional dysregulation, recovery and psychological flexibility in inpatients with primary psychoses. The Primary outcome assessed the positive and negative syndrome scale, while the secondary outcomes were to assess difficulties in the emotion regulation scale, recovery assessment scale and acceptance and action questionnaire. An open-label, two-arm parallel randomized controlled trial was conducted. Participants diagnosed with primary psychoses were randomly assigned to either the ACT (n = 33) or treatment-as-usual (n = 32) group. The intervention included six structured sessions of ACT. ACT significantly reduced psychotic symptoms from 128 to 104 (Z = 5.01) compared to treatment as usual from 130 to 117 (Z = 4.88). Emotional regulation improved significantly in the ACT group from 73 to 55 (Z = 4.835) compared to treatment as usual from 73 to 70 (Z = 2.406). Recovery increased in the ACT group from 50 to 88 (Z = 5.01) compared to treatment as usual from 51 to 61 (Z = 4.93). Psychological flexibility improved in the ACT group from 33 to 25 (Z = 4.98) compared to treatment as usual from 33 to 31 (Z = 4.75). Between-group differences after intervention were significant for psychotic symptoms, emotional regulation, recovery and psychological flexibility (Z = 2.356, 4.652, 3.881 and 4.453, respectively). Accordingly, the current study demonstrates the effectiveness of ACT in reducing psychotic symptoms and improving emotional regulation, recovery and psychological flexibility in patients with primary psychoses. Integrating ACT into standard care protocols can enhance treatment outcomes, offering a comprehensive approach to managing complex mental health conditions. Trial Registration: ClinicalTrials.gov identifier: NCT06160869.

Decent work and ethical ideologies of nurses-A multicenter cross-sectional study.

Background: Although research has established that the work environment significantly shapes nurses' ethical behavior, it's less clear whether decent work could influence ethical ideologies of nurses. Aim: To investigate the decent work conditions and ethical ideologies of nurses, and to analyze whether decent work influences their ethical ideologies. Methods: A multicenter cross-sectional survey was conducted among 203 nurses working in three tertiary governmental hospitals across two cities in Egypt. We utilized the Scale of Decent Work, which consists of 15 items distributed across five dimensions, to assess the level of decent work conditions. Additionally, the Ethics Position Questionnaire, containing 20 items divided into two categories-idealism and relativism-was used to evaluate the ethical ideologies of nurses. Pearson correlation and linear regression analyses were applied to analyze the data. Ethical considerations: Ethical approval from the ethics committee, institutional permission, and informed consent from the participants were obtained for data collection. Results: The findings indicated that the levels of decent work conditions were moderate, while the ethical ideologies of nurses were relatively high. Stepwise multiple linear regression analyses revealed that the idealism of nurses was significantly predicted by two dimensions of decent work-organizational values, and hours allowing for free time and rest-along with the overall decent work score. Meanwhile, the relativism of nurses was significantly predicted by the presence of physically and interpersonally safe working conditions. Conclusions: Nurses experiencing decent work conditions characterized by high organizational values and adequate hours for free time and rest are more inclined to adopt idealistic ethical ideology. Meanwhile, those experiencing physically and interpersonally safe working conditions tend to embrace relativistic ethical ideology. Implications for clinical practice: Identifying the relationship between decent work conditions and the ethical ideologies of nurses can assist hospital administrators in fostering work conditions that promote appropriate ethical ideologies among nurses.

TRANSLATION, ADAPTATION, AND VALIDATION OF AN ARABIC VERSION OF HUMAN RESOURCE PRACTICES SCALE AMONG NURSES.

Background and Purpose: Nursing human resource practices (HRP) have a unique role in healthcare organizations. Nevertheless, there is no valid and reliable Arabic tool measuring nursing HRP has been published. The present study aimed to translate, culturally adapt and validate the HRP scale into the Arabic language among nurses. Methods: A methodological study was applied in a sample of 328 nurses from 16 hospitals in Port-Said, Egypt. Results: The scale had good content and concurrent validity. Confirmatory factor analysis showed a better fit for the second-order. Cronbach's alpha was 0.95, and the intra-class correlation coefficient was 0.91 for the total scale showed good reliability. Conclusion: The scale application is recommended in clinical and research settings to assess HRP among Arabic nurses.