Nurses' safety climate, quality of care, and standard precautions adherence and compliance: A cross-sectional study.

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.

A 5-Week Guided Active Play Program Modulates Skin Microvascular Reactivity in Healthy Children.

PURPOSE: Children's poor levels of physical activity (PA) participation and early-onset vascular aging are identified as global health challenges. Children's guided activity play (GAP)-based PA programs have emerged as effective strategies to improve cardiovascular risk factors and health-related fitness. This study proposes to investigate whether GAP improves children's cutaneous microvascular reactivity and health-related fitness. METHODS: Children's (n = 18; 9.8 [1.5] y) PA during a 5-week (4 d/wk; 1 h/d) GAP program was assessed (accelerometry) with preassessments and postassessments for anthropometric, musculoskeletal fitness, blood pressure, estimated aerobic power, and cutaneous microvascular reactivity. RESULTS: PA averaged 556 (132) kcal·week-1 at 34.7% (7.5%) time at moderate to vigorous intensity. Resting heart rate (-9.5%) and diastolic blood pressure (-7.8%) were reduced without changes in health-related fitness indices. Cutaneous microvascular reactivity to sodium nitroprusside iontophoresis increased the average perfusion (+36.8%), average cutaneous vascular conductance (+30%), the area under the curve (+28.8%), and a faster rise phase (+40%) of perfusion (quadratic modeling; P ≤ .05). Chi-square and crosstabulation analysis revealed significant association between children's PA levels and sodium nitroprusside average perfusion levels, where children with PA levels ≥205.1 kcal.55 minute-1 were overrepresented in the medium/high levels of sodium nitroprusside perfusion. CONCLUSION: A 5-week GAP modified the microvascular reactivity in children without changes in body mass, musculoskeletal fitness, or estimated aerobic power.

RETRACTED: Safety climate, quality of care, adherence to and compliance with standard precautions among nurses: Structural equation modeling.

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.

Nurses' professional values and competency in Saudi Arabia: A structural equation modelling approach.

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.

Academic stress, COVID-19 anxiety, and quality of life among nursing students: The mediating role of resilience.

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.

Moral Distress, Moral Resilience, Moral Courage, and Moral Injury Among Nurses in the Philippines During the COVID-19 Pandemic: A Mediation Analysis.

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.

Structural equation modelling of ethicomoral values and competence of nurses during the COVID-19 pandemic.

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.

Filipinos' health information-seeking behaviors and their implications for COVID-19 vaccination.

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.

The moderating effect of burnout on professionalism, values and competence of nurses in Saudi Arabia amidst the COVID-19 pandemic: A structural equation modelling approach.

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.

Quality of life and academic resilience of Filipino nursing students during the COVID-19 pandemic: a cross-sectional study.

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.

Guided Active Play Promotes Physical Activity and Improves Fundamental Motor Skills for School-Aged Children.

Reports show that children's physical activity (PA) levels are related to FMS proficiency; however, whether PA levels directly improve FMS is uncertain. This study investigated the responses of PA levels and FMS proficiency to active play (AP) and guided active play (GAP) interventions. Three community programs (seven-weeks; 4d·wk-1) were randomly assigned to: i) active play (CON); ii) locomotor skills (LOC) guided active play (GAP); and iii) object control skills (OC) GAP groups. Children's (n = 52; 6.5 (0.9) yr) interventions included continuous and/or intermittent cooperative games focused on either locomotor skills (i.e. blob tag, red-light-green-light) or object control skills i.e., hot potato, racket balloons, 4-way soccer). PA levels (accelerometers) were assessed on 2 of 4 sessions per week throughout the program. The Test of Gross Motor Development-2 (TGMD-2) was used to assess FMS scores. The changes for CON and LOC interventions for locomotor standard scores were -0.83 (2.61) vs. 2.6 (2.64) (α = 0.022), for locomotor percentiles -9.08 (36.7) vs. 20.1 (30.4) (α = 0.033) and for gross motor quotient percentiles -4.3 (30.3) vs. 24.1 (29.6) (α = 0.022). Children's PA levels averaged 158.6 (6.6) kcal·55min-1 for CON vs. 174.5 (28.3) kcal.55min-1 for LOC (α = 0.089) and 170.0 (20.1) kcal·55min-1 for OC (α = 0.144). Moderate-Vigorous PA was 18.4 (8.0) %, 47.9 (7.8) % (α = 0.000) and 51.9 (6.0) % (α = 0.000) for CON, LOC and OC, while time at sedentary/very light PA was 36.4 (9.8) %, 15.1 (4.9) % (α = 0.000) and 14.9 (15.9) %Sed/VL (α = 0.001) during the 7-week program. The OC intervention showed more upper body movement experiences compared to the LOC program (p = 0.020). A guided active play program using LOC cooperative games showed increases in energy expenditure and %MVPA and improved FMS proficiency, but active play did not. For school-aged children (5-7 yr) guided active play using cooperative games may be an effective strategy to improve FMS and promote health and fitness benefits.

Directional secretomes reflect polarity-specific functions in an in vitro model of human bronchial epithelium.

The polarity of the conducting airway epithelium is responsible for its directional secretion. This is an essential characteristic of lung integrity and function that dictates interactions between the external environment (apical) and subepithelial structures (basolateral). Defining the directional secretomes in the in vitro human bronchial epithelial (HBE) differentiated model could bring valuable insights into lung biology and pulmonary diseases. Normal primary HBE cells (n = 3) were differentiated into respiratory tract epithelium. Apical and basolateral secretions (24 h) were processed for proteome profiling and pathway analysis. A total of 243 proteins were identified in secretions from all HBE cultures combined. Of these, 51% were classified as secreted proteins, including true secreted proteins (36%) and exosomal proteins (15%). Close examination revealed consistent secretion of 69 apical proteins and 13 basolateral proteins and differential secretion of 25 proteins across all donors. Expression of Annexin A4 in apical secretions and Desmoglein-2 in basolateral secretions was validated using Western blot or ELISA in triplicate independent experiments. To the best of our knowledge, this is the first study defining apical and basolateral secretomes in the in vitro differentiated HBE model. The data demonstrate that epithelial polarity directs protein secretion with different patterns of biological processes to the apical and basolateral surfaces that are consistent with normal bronchial epithelium homeostatic functions. Applying this in vitro directional secretome model to lung diseases may elucidate their molecular pathophysiology and help define potential therapeutic targets.

"Notice of major cleaning": A qualitative study of the negative impact of encampment sweeps on the ontological security of unhoused people who use drugs.

BACKGROUND: Unhoused people who use drugs in the United States are at risk for a variety of negative health outcomes. As the crisis of houselessness continues to impact major urban areas, a wave of punitive policies has been enacted to remove visible unhoused people from public spaces. There is reason to believe that harsh policies of encampment displacement will have negative immediate and downstream impacts on this community. METHODS: Participant observation was conducted weekly or bi-weekly at unhoused encampments in Los Angeles County, USA over the course of two years (2021, 2022). Data were generated through the lens of ontological security theory via in-field jottings and comprehensive field notes. Formal, semi-structured qualitative interviews were conducted with 30 unhoused people who use drugs recruited primarily through peer-referral sampling at these same venues. Data were coded and analyzed thematically using the Template Analysis approach. Field notes were used to triangulate and further contextualize thematic analysis of interview data. RESULTS: Encampment sweeps impacted nearly all participants and occurred multiple times at every visited field site. They were observed to occur both with and without the presence of police, but always resulted in the loss of the personal property of encampment residents. Sweeps occurred across seasons, hazardous weather, and without offers of alternative shelter. Participants described sweeps as impacting all aspects of their ontological security, including dismantling material and social constancy, disrupting routines of daily life and resource management, increasing feelings of surveillance, and potentially creating negative identity formation. CONCLUSIONS: In both ethnographic observation and participant interviews, encampment sweeps were noted to be physically, psychologically, and socially destructive. Sweeps left participants feeling anger, loss, and hopelessness while further driving the societal marginalization of unhoused people who use drugs. Sweeps should be discontinued as they harm the capacity of unhoused people to improve their well-being.

Nursing students' nomophobia, social media use, attention, motivation, and academic performance: A structural equation modeling approach.

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.

Nursing students' perceived stress, social support, self-efficacy, resilience, mindfulness and psychological well-being: A structural equation model.

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.

Psychometric testing of the nurse professional competence scale Arabic version: An exploratory and confirmatory factor analyses.

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.

Cardiorespiratory and metabolic responses associated with children's physical activity during self-paced games.

The aim of this study was to explore the possibility of identifying clusters of children's games based on estimated energy expenditures and (or) intensity when performed in a guided active play format. The study also investigated whether the identified active play game clusters were repeatable when the games were performed on different days. Children (9.7 ± 1.1 years; n = 12) were assessed for oxygen consumption, heart rate, energy expenditure (EE), and metabolic equivalent (MET) on a treadmill (at 4, 6, and 8 km·h(-1) (0% grade)). HR and ActiGraph GT1M accelerometer (ACC) generated linear regression equations were used to estimate EE. The ACC (3 s epochs) were used for estimating METs in assigning percent time at medium-vigorous physical activity (%MVPA) of 10 self-paced games. The results showed a consistent range of EEs (ACC-equation) from 13.57 kcal·(5 min)(-1) to 25.00 kcal·(5 min)(-1) (p < 0.05); EEs (HR-equation) from 29.72 to 42.49 kcal·(5 min)(-1) (p < 0.05); and %MVPA from 10% to 34% (p < 0.05) (from ACC equations) across all games. These were reproducible from day to day (p > 0.05). This study confirms the existence of active play children's game clusters that might be useful in formatting guided active play in a dose-response manner for children.

Nursing competency inventory and professional competence of graduating students in six Asian countries: A cross-sectional study.

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.

Structural equation modeling of the relationship between nursing students' quality of life and academic resilience.

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.

Parental authority as a mediator between career decision-making self-efficacy, career decision ambiguity tolerance, and career choice of nursing students: A path analysis.

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.