Background and Purpose: Older people living with HIV (OPLWH) face complex challenges as they age. Although advances in antiretroviral therapy have transformed human immunodeficiency virus (HIV) infection into a chronic condition and increased longevity, aging with HIV is often accompanied by multimorbidity, polypharmacy, stigma, social isolation, and mental health concerns. These intersecting factors complicate clinical management and are not always fully addressed in traditional HIV care models. Methods: This study aimed to explore the clinical care experiences of OPLWH over age 50. A qualitative descriptive inquiry was undertaken to gain an in-depth understanding of participants' experiences. Semistructured individual interviews were conducted with 16 OPLWH. All interviews were audio-recorded and transcribed verbatim. Data were analyzed using thematic analysis, following an iterative process of coding, categorization, and theme development to identify patterns across participants' narratives. Results: Five key themes emerged: (a) looking beyond the virus and T-cells; (b) detecting emerging health needs related to aging with HIV; (c) identifying and addressing psychological and social needs; (d) addressing barriers to accessible and coordinated care; and (e) supporting patient empowerment, advocacy, and education. Participants required more comprehensive support in advocacy, social connection, care accessibility, and care coordination. Conclusions: Findings reveal critical gaps in nursing practice and emphasize the need for patient-centered, holistic care for OPLWH. Nursing practice should incorporate comprehensive assessments that address physical, psychological, and social domains; enhance interdisciplinary collaboration; and prioritize proactive screening for age-related comorbidities, mental health concerns, and social determinants of health. Future research should develop and evaluate interventions designed to reduce loneliness and social isolation and enhance social connectedness among OPLWH.

Background and Purpose: Natural disasters such as earthquakes create major challenges for families managing chronic illnesses, particularly children with diabetes. Earthquake-related stress intensifies the demands of disease management and increases family burden. Guided by the Family Management Style Framework, this study examined how parents' coping with earthquake stress influences their ability to manage their child's condition. Method: A descriptive, cross-sectional study was conducted with 140 parents of children with diabetes receiving care at a training and research hospital. Data were collected between March and June 2023 using an Information Form, Coping with Earthquake Stress Scale, and Family Management Measure. Descriptive statistics, Pearson correlation analysis, and multiple linear regression were used to analyze the data. Results: The findings revealed significant relationships between coping strategies and family management outcomes. Disease management was positively associated with family functioning (p < .05), while life challenges and lower parental agreement were negatively correlated with family management scores (p < .05). Regression analysis showed that earthquake stress coping strategies significantly predicted family management outcomes, explaining 26.2% of the variance (R[2] = .262, F = 2.402, p = .021). Implications for Practice: The parents' coping with earthquake-related stress is a significant predictor of family management outcomes, explaining 26.2% of the variance. Interventions that strengthen adaptive coping strategies, enhance family functioning, and support parental agreement may improve chronic disease management in children with diabetes following disasters. Health care professionals should prioritize psychosocial support and family-centered education to mitigate life challenges and support effective disease management in postearthquake settings.

Background: Moyamoya disease is a chronic cerebrovascular condition requiring ongoing self-management to prevent complications. Riegel's theory of self-care in chronic illness posits that factors such as disease knowledge, self-efficacy, social support, and access to care influence self-care maintenance, monitoring, and management, which in turn affect health outcomes and quality of life (QoL). Aim: To test a structural equation model of factors influencing self-care and outcomes in adults with moyamoya disease based on Riegel's self-care theory. Methods: A cross-sectional survey of 211 adults with moyamoya disease collected data on disease knowledge, self-efficacy, social support, access to care, self-care maintenance, monitoring, management, health status, and QoL (Korean version of the 12-Item Short Form Health Survey). Structural equation modeling was performed using IBM SPSS Statistics 30.0 and AMOS 30.0 to test the hypothesized model. Results: The proposed model demonstrated good fit. Disease knowledge, self-efficacy, social support, and access to care were significantly associated with self-care maintenance, monitoring, and management. These self-care processes, in turn, were positively related to better health status and higher QoL. The model explained a substantial proportion of variance in health status and QoL. Conclusion: The findings support the applicability of Riegel's self-care theory in moyamoya disease. Interventions to enhance patients' disease knowledge, self-efficacy, social support, and access to care may improve self-care and ultimately lead to better health outcomes and QoL in this population.

Background and Purpose: Understanding the factors that influence nurses' willingness to volunteer during disasters is essential for fostering their active and sustained involvement in disaster preparedness efforts. The aim of the study is to conduct a concept analysis on nurses' volunteerism in disaster situations. Methods: Walker and Avant's concept analysis method was used to examine the concept of volunteering. Literature search was conducted in Web of Science, PubMed, ProQuest, ScienceDirect, and CINAHL (Cumulative Index to Nursing and Allied Health Literature) Ultimate databases until July 2025 without any start date restrictions. Electronic databases were searched using the terms "Volunteer" OR "Volunteering" OR "Voluntarism" OR "Volunteerism" AND ("Disaster" OR "Emergency" OR "mass casualty incidents" OR "natural disaster" OR "humanitarian response") AND ("Nursing" OR "Nurse" OR "Nurs*"). Results: In the 44 studies analyzed, the main characteristics (social and professional responsibility, adaptability, teamwork, and ethical dimension), antecedents (individual and professional identity, disaster education, motivation and commitment, and incentives), and outcomes (professional and personal development, contribution to disaster health care, and social benefits) of volunteering in nursing during disasters were defined. Conclusions: This concept analysis revealed a preliminary model that includes the basic characteristics, antecedents, and consequences of volunteering in nursing during disasters. The model contributes to understanding the multidimensional nature and dynamic structure of volunteerism. Implication for Nursing Practice: This conceptual analysis defines volunteering in disaster situations as follows: characterized by social and professional responsibility, adaptability, teamwork, and ethical dimension; arising from individual and professional identity, disaster training, motivation and commitment, and incentives; and promoting personal, professional, and social benefits.

Background: The concept of professional identity is gaining traction within the nursing profession through intentional steps to define the concept and include it as an educational benchmark for all nurse graduates. Defining attributes of professional identity differ across professions, which necessitates comparison for a robust understanding. Purpose: The aim of this conceptual analysis is to identify defining attributes of one's professional identity in nursing by comparing conceptual usage of professional identity throughout history and current defining attributes within the professions of medicine, engineering, and teaching using the Walker and Avant method. Articles appraising the history of the concept of professional identity, conceptual definitions, or defining attributes within the profession were synthesized for comparison. Results: The nursing profession was late to recognize and conceptualize professional identity for individual nurses when compared with medicine, engineering, and teaching. Conceptualization of professional identity has surged in the last decade. Defining attributes of one's professional identity include perception and feeling as a member of a profession; individual values, beliefs, and actions that align with the larger profession; understanding of a distinct practice; foundational research-based knowledge through formal and ongoing education; and reflection on relationships and experiences that impact values and beliefs throughout a career. Implications for the Profession: A more robust conceptualization of professional identity has the capability of enhancing nursing theory, research, and practice to establish nurses with a strong sense of belonging within the profession.

Background and Purpose: Barriers to patient recruitment, retention, and diversity are persistent challenges in clinical trials (CTs). With little evidence to advise best practices, clinical trials nurses (CTNs) remain an overlooked, patient-oriented resource. Applying a theoretical lens when investigating a complex problem ensures scientifically grounded inquiry and robust interpretation. The aims of this work were to evaluate the utility of D'Amour's structuration model of collaboration (SMC) for clarifying CTN roles and contributions; analyze how barriers to CTN collaboration affect research patient burden, safety, and participation; and examine how collaborative structures within the industry influence CTN involvement in CT design and conduct. Methods: SMC was selected as the theoretical mechanism because it functions reliably across organizational boundaries. A focused, theory-guided literature review was performed to map relevant evidence. Results: Findings indicated that CTNs represent a small, complex, and understudied specialty. Due to this niche status, CTNs have had limited representation within networks that facilitate disciplinary oversight and proactive patient advocacy. SMC articulates this relegation to downstream study operations. Although shared goals exist, a lack of CTN expertise in early study development perpetuates inefficiencies. This latent degree of collaboration is rooted in weak internalization and hindered by absent formalization and governance structures. Implications: CTNs are frequently cited as experts who enhance CT safety and overall success; however, this has not been thoroughly quantified. Therefore, in addition to CTN inclusion during CT design and protocol development, their consultative scope and impact must also be systematically measured and disseminated. Cultivating this knowledge could elevate CTN subspecialties into advanced practice status.

Background: Caring is central to nursing practice and education. While simulation is an effective modality to support the teaching of both technical and nontechnical skills, its impact on nurses' and nursing students' empathy and caring behaviors is less clear. Methods: A scoping review, guided by Arksey and O'Malley, Levac et al., and Joanna Briggs Institute frameworks and reported per Preferred Reporting Items for Systematic reviews and Meta-Analyses extension for Scoping Reviews, searched CINAHL, PsycInfo, MEDLINE, and Health Source: Nursing/Academic Edition. The inclusion criteria were original research or randomized controlled trial, use of simulated patients, nursing participants, and outcomes related to empathy or caring behaviors. Results: Of the 129 studies, 8 met the criteria (2019-2023). All reported improvements in self-perceived empathy and caring across various study designs. Conclusions: Simulation may enhance empathy and caring, though further research is needed to confirm causality.

Background and Purpose: Menopause is a significant life stage that requires provider awareness and patient education to support informed decision-making. Inconsistent provider knowledge and increasing menopause-related concerns among perimenopausal women in a primary care clinic contributed to variability in assessment, counseling, and management. This project implemented a structured, evidence-based menopause education intervention to improve patient knowledge and support informed discussions in primary care. Methods: This 6-week quality improvement project enrolled women aged 40-55 years presenting for routine care or menopause-related symptoms. Participants completed anonymous pre- and postintervention surveys assessing menopause knowledge. The intervention consisted of a provider-guided education session using an evidence-based trifold pamphlet addressing symptom recognition, treatment options, lifestyle recommendations, and preventive health. Only fully completed surveys were included in the analysis. Results: Ninety-eight percent of participants reported the intervention as relevant to their needs. Survey findings demonstrated improved menopause knowledge. The structured pamphlet facilitated patient-provider discussions and increased awareness. Implications for Practice: Structured menopause education in primary care can improve health literacy, support informed decision-making, and enhance patient-provider communication. Promoting earlier recognition of symptoms can improve the quality of life for menopausal women.

Background: Annually, approximately 170,000 persons in the United States transition from foster care to independent adulthood, often with an abrupt discontinuation of essential support services. The immediate loss of vital supports often triggers a cascade of instability that flows into the financial, guardianship, and safety sectors. Purpose: The purpose of this review was to examine the small body of literature that explicitly applies Meleis's Transition Theory to the experiences of individuals aging out of foster care and to synthesize the literature to more effectively assess transition conditions, patterns of response, and nursing therapeutics for this population. Methods: A theory-guided, integrative review was conducted to enhance the understanding of holistic, multifaceted phenomena. The articles were synthesized through the lens of Transition Theory to deepen understanding and inform nursing care planning for individuals aging out of foster care. Results: Findings were synthesized across three theory-informed domains: transition conditions, patterns of response, and nursing therapeutics. Across the studies, the literature consistently highlighted the importance of relational support, preparation for independence, and coordinated, transition-focused nursing interventions. Implications for Practice: Nurses encounter this population across a variety of clinical and community settings and are well-positioned to support healthy transitions to independence. Meleis's Transition Theory assists nurses caring for this population in recognizing vulnerability, preventing secondary trauma, and connecting patients to resources beyond their scope of practice.

Background and Purpose: Nursing students need to recognize when clinical cues are important or nonessential. By using signal detection theory (SDT) to guide the analysis of nursing student responses, nurse educators can understand and categorize student learning needs to direct remediation. The purpose of this study is to describe and compare the nursing student- and nurse educator-identified needs for remediation after participating in a signal detection trial study for patient deterioration. Methods: A secondary analysis of qualitative data from a mixed-methods study that examined a convenience sample (n = 14) of second-semester senior nursing students from a cohort at a private university was conducted for the identified concept of remediation. The original data were collected using semistructured individual interviews, using a convenience sample. Data were analyzed using content analysis. Results: Two concepts emerged: student-identified remediation and researcher-identified remediation, with subconcepts of knowledge gaps and thinking deficits. Knowledge gaps included when students could not remember relevant information or when the researcher noted incorrect knowledge. Thinking deficits included when data were connected incorrectly or the wrong decision was made. Implications for Practice: Using SDT allowed researchers to identify the errors students were making in order for educators to better categorize errors and plan for effective remediation.

Background: Emotional intelligence is increasingly recognized as a key component of effective clinical leadership; however, its role in nurse managers' everyday clinical practice remains insufficiently understood. Aim: This study aimed to explore nurse managers' emotional intelligence and to examine how it shapes clinical leadership and care processes, based on the Emotional Intelligence and Leadership Competence Model. Methods: A qualitative phenomenological design was employed. Data were collected between January and April 2023 through semistructured interviews with 20 first-level nurse managers working in a training and research hospital in Turkey. The data were analyzed using thematic analysis based on the Emotional Intelligence and Leadership Competence Model. The study was reported in accordance with the Consolidated Criteria for Reporting Qualitative Research. Results: Four main themes and 15 subthemes emerged: (a) self-awareness, (b) self-management, (c) social awareness, and (d) relationship management. Self-awareness supported reflective practice, while self-management enabled regulation of emotional responses in high-risk situations. Social awareness facilitated early recognition of team-related risks and supported patient-centered care through empathy. Relationship management strengthened communication, teamwork, and continuity of care within psychologically safe environments. Overall, emotional intelligence emerged as a process-based mechanism linking individual competencies to team functioning and safe care delivery. Conclusions: Emotional intelligence operates as an integrated system rather than a set of isolated competencies, shaping team dynamics, clinical decision-making, and safe care delivery. This study extends the model by illustrating how emotional intelligence is enacted in real clinical leadership contexts, positioning it as a core mechanism of clinical leadership.

Background: Navigating role transitions is often challenging and complex, regardless of career stage, setting, or role type, and occurs across all fields of nursing, from student to advanced practice. Purpose: This work offers a conceptual review examining how vulnerability, emotional intelligence, resilience, and psychological safety affect the development and management of impostor syndrome during nursing career transitions, drawing on Meleis' Transitions Theory. Methods: A structured search of the literature was conducted, and the evidence was conceptually synthesized using Meleis' Transitions Theory as a guiding framework. Vulnerability, emotional intelligence, resilience, and psychological safety were chosen because they represent both internal adaptive processes and environmental factors that influence how nurses interpret and respond to impostor feelings during role transitions. Findings: Vulnerability, emotional intelligence, resilience, and psychological safety interact as complementary factors influencing the development and management of impostor syndrome during nursing role transitions while supporting healthy adaptation and professional role development. Discussion: Implications for nursing practice emphasize the importance of nursing-specific education and mentorship to support successful role transitions and mitigate impostor syndrome.

Background and Purpose: Given the unique therapeutic challenges that kidney transplant recipients with posttransplantation diabetes mellitus face, understanding how self-care confidence influences self-care maintenance is paramount. This study aimed to examine the mediating role of self-care confidence in the association between health literacy and self-care maintenance among kidney transplant recipients with posttransplantation diabetes mellitus. Methods: This study used a cross-sectional, descriptive, and correlational design. A convenience sample of 109 participants was recruited from a single tertiary hospital, and participants completed a web-based questionnaire. The mediation analysis was conducted using the percentile bootstrap method, controlling for participants' general characteristics. Results: Health literacy was significantly associated with self-care maintenance (β = 0.46, p < .001, 95% confidence interval [CI] [0.44, 1.29]). Including self-care confidence reduced the direct effect (β = 0.37, p = .001, 95% CI [0.31, 1.08]), indicating partial mediation. The completely standardized indirect effect was significant (β = 0.18, 95% CI [0.07, 0.32]), and the model explained 45% of the variance in self-care maintenance (R[2] = .45). Implications for Practice: Strengthening self-care confidence may enhance self-care maintenance, while ongoing strategies to support health literacy remain important.

Aim: To report an analysis of the concept of moral distress among nurses caring for undocumented immigrants (UIs). Design: Concept analysis is the study design. Data Sources: Data sources included nursing and health care databases searched from 2015 to 2025. Eight articles were identified that addressed moral distress in the context of nursing care for UIs. Review Methods: Walker and Avant's method was used to identify definitions, antecedents, consequences, and empirical referents of the concept. Model, related, and contrary cases were developed to illustrate conceptual boundaries. Results: Defining attributes of moral distress among nurses caring for UIs included moral awareness, perceived or actual constraints, emotional and psychological distress, conflict between professional role and structural injustice or advocacy, and capability for reflection and growth. Antecedents were awareness of an ethical obligation or right action and encounters with UIs facing policy, institutional, or legal barriers. Consequences encompassed emotional and psychological effects such as guilt, frustration, sadness, burnout, and job dissatisfaction or turnover, moral residue, compromised patient care, and questioning of professional identity and values. Empirical referents included the Moral Distress Scale-Revised and the Moral Distress Thermometer. Conclusion: Moral distress is a pervasive and underexamined phenomenon for nurses who care for UIs. The analysis demonstrates that systemic constraints and ethical conflicts contribute to significant personal and professional consequences for nurses, ultimately threatening both workforce sustainability and delivery of equitable care. Conceptual clarity and empirical tools adapted for this context are needed to inform effective interventions.

Aim: The aim of this study was to identify the factors influencing preschool children's daily smartphone and tablet use and to evaluate the relative importance of these factors using machine learning models. Furthermore, the findings were discussed within the framework of Bandura's Social Learning Theory to examine the parental and environmental influences shaping children's screen time. Methods: This study was conducted in a district of Central Anatolia, Turkey, with data collected from the parents of children aged 4-6 years (N = 266). The data included children's daily screen time, purposes of device use, and parental digital habits. Analyses were performed using logistic regression, support vector machines, artificial neural networks, and XGBoost algorithms. Model performance was compared in terms of accuracy, F1 score, sensitivity, specificity, and area under the ROC curve values. Feature importance was also examined. Results: The child's purpose of device use was found to be the strongest predictor of screen time. In particular, using devices for educational content and turning to devices when bored were the most prominent determinants. Parents' daily screen use exceeding 3 hours and frequent social media use also significantly increased children's screen time. Parental guidance behaviors (e.g., coviewing content and setting limits) showed significant effects, whereas demographic factors contributed to a lesser extent. Conclusion: The study demonstrates that children's screen time is shaped not only by demographic characteristics but also by usage purposes and parental digital habits. It is recommended that parents act as role models, provide guidance in content selection, and enforce restrictions during critical periods.