Nursing Practice Today

Improving early detection of breast cancer in Iran: Identifying barriers and proposing policy solutions

Maryam Janatolmakan, Marziyeh Lashkari, Rebecca Lehto, Reza Negarandeh — Wed, 06 May 2026 10:41:29 +0000

Background & Aim: Delays in early breast cancer detection increase late-stage presentation, treatment burden, mortality, and costs. Barriers are systemic (access, affordability), individual (fear, awareness), and socio-cultural (stigma, beliefs). This policy brief aims to improve early detection in Iran by identifying barriers and proposing solutions.

Methods & Materials: This policy brief was developed through a multi-phase, evidence-informed study with a multidisciplinary panel. Phase 1 employed a scoping review to identify factors contributing to delayed breast cancer diagnosis globally. Phase 2 utilized semi-structured qualitative interviews with Iranian patients and healthcare providers to explore real-world barriers to early detection. Phase 3 applied an expert consensus approach to prioritize evidence-based, context-specific policy recommendations for improving early breast cancer diagnosis in Iran. The expert panel in Phase 3 comprised specialists from Radiation Oncology, Public Health, Health Education & Promotion, Medical Oncology, and Nursing.

Results: Policy recommendations were derived across five key priority areas: Enhancing equitable access to screening services; Strengthening follow-up and continuity of care systems; Improving health education and awareness; Promoting intersectoral coordination and multisectoral governance; and Ensuring sustainability of resources and digital infrastructure.

Conclusion: Initiating strategies to address these public health recommendations could substantially improve early breast cancer detection rates, reduce mortality, improve patient quality of life, and enhance the overall efficiency of the health system. Moreover, this framework may serve as a scalable model for managing non-communicable diseases in resource-limited settings.

Emerging digital health approaches for the detection of undiagnosed type 2 diabetes mellitus in underserved populations: A scoping review

Andi Sulfikar, Rini Rachmawaty, Elly Lilianty Sjattar — Wed, 06 May 2026 10:44:41 +0000

Background & Aim: Undiagnosed type 2 diabetes mellitus continues to pose a major global health challenge, especially in underserved populations facing limited access to screening. Digital health technologies present scalable alternatives to improve early detection and prevent complications. This scoping review aims to map digital health approaches for detecting undiagnosed type 2 diabetes mellitus in underserved adult communities and analyze screening outcomes, feasibility, and key implementation factors.

Materials & Methods: The review followed the Arksey and O’Malley scoping framework and was reported using PRISMA-ScR guidelines. Systematic searches were performed in PubMed/MEDLINE, Scopus, Web of Science, and CINAHL for studies published in English from 2015 onward. Two reviewers independently screened articles, with conflicts resolved through consensus. Data were synthesized narratively to identify digital modalities, screening strategies, effectiveness indicators, and enablers or barriers.

Results: Nineteen studies were included, identifying five categories of digital interventions. Electronic health record–driven screening was reported in 5 of 19 studiesand was the most frequently reported modality, alongside mHealth applications, SMS-based detection support, telehealth platforms, and wearable tools. Digital risk-based screening integrated within community or primary care pathways demonstrated the widest reach and highest identification of undiagnosed dysglycemia. Simpler digital solutions showed greater acceptability and feasibility than complex systems, particularly in settings with limited digital literacy or connectivity.

Conclusion: Digital health technologies show strong potential to expand early detection of undiagnosed type 2 diabetes mellitus in underserved populations. System-integrated, low-burden, and equity-centered screening models are most promising. Strengthening linkage to care and improving digital accessibility remainpriorities for future research.

Effects of oropharyngeal colostrum and minimal enteral nutrition on respiratory morbidity and necrotizing enterocolitis in preterm infants: A systematic review of randomized trials

Maryam Zarafrooz, Jamalodin Begjani — Wed, 06 May 2026 10:46:59 +0000

Background & Aim: Necrotizing enterocolitis is one of the most severe gastrointestinal complications in premature infants, characterized by acute intestinal inflammation and progressive mucosal damage. This systematic review aimed to evaluate the effects of minimal enteral nutrition and oropharyngeal or buccal colostrum administration on respiratory morbidity and the incidence of necrotizing enterocolitis in preterm neonates.

Materials & Methods: A comprehensive search was conducted using PubMed, Web of Science, Scopus, ProQuest, and Google Scholar databases. From 10,460 identified records, twelve randomized controlled trials published between 2015 and 2024 met inclusion criteria and were incorporated into the qualitative synthesis. Data were extracted regarding early growth, feeding tolerance, immune biomarkers, and safety outcomes.

Results: Minimal enteral nutrition was associated with improved early growth and reduced feeding intolerance. Oropharyngeal or buccal exposure to colostrum increased mucosal immune biomarkers, including immunoglobulin A, immunoglobulin M, and lactoferrin, and promoted early colonization of beneficial intestinal microorganisms. Some trials reported reductions in late‑onset sepsis and retinopathy of prematurity. However, neither minimal enteral nutrition nor colostrum‑based interventions significantly reduced the incidence of necrotizing enterocolitis (p > 0.05). Both approaches showed favorable safety profiles without increased adverse effects or clinical instability.

Conclusion: Minimal enteral nutrition and oropharyngeal or buccal colostrum administration appear to be safe, feasible, and biologically plausible strategies for enhancing early nutrition and mucosal immunity in premature infants. Larger, multicenter, and standardized clinical trials are warranted to determine their definitive impact on necrotizing enterocolitis prevention.

Nurses’ perception of nurse-physician collaboration at emergency departments in the Gaza governorates

Ahmed Jenanah, Mohammed Jebreldar Abuanja, Yousef Fathi Fahajan — Wed, 06 May 2026 10:56:47 +0000

Background & Aim: Nurse-physician collaboration is a fundamental component of interprofessional healthcare, where nurses and physicians share responsibilities and work-related goals to improve patient outcomes. This study aims to assess nurses' perceptions of nurse-physician collaboration in the emergency departments in Gaza Governorate, Palestine.

Methods & Materials: A cross-sectional study was conducted between January and April 2023, involving a census sample of 205 emergency department nurses working in Ministry of Health hospitals. Data were collected using the Jefferson Scale of Attitudes toward Physician–Nurse Collaboration, a 15-item questionnaire that quantifies these attitudes in a meaningful way. Higher scores indicate a more positive attitude toward interprofessional collaboration. Four domains (shared education and collaboration, responsibility and role expectations, nurses’ autonomy, and physicians’ authority) represent the intricate factors that influence IPC in Ministry of Health hospitals. A validated self-administered questionnaire was employed.

Results: The findings revealed a high level of nurse-physician collaboration in governmental hospital emergency departments in Gaza, with an overall weighted mean of 78.4%, indicating a positive perception among nurses. Among the four dimensions of nurse-physician collaboration, nurse autonomy ranked highest (88.2%), followed by responsibility and role at 87.9%, and shared education & collaboration at 87.3%. However, physician authority ranked lowest, with a relative weight of 50.0%, suggesting a perceived imbalance in decision-making authority within emergency departments.

Conclusion: The study highlights a strong positive attitude toward nurse-physician collaboration among nurses in Gaza’s governmental hospital emergency departments. However, the low perception of physician authority suggests the need for further investigation into interprofessional dynamics

The effect of extended PLISSIT model-based counseling on sexual satisfaction in women with systemic lupus erythematosus: A randomized controlled trial

Wed, 06 May 2026 11:02:11 +0000

Background & Aim: Systemic Lupus Erythematosus has physiological, cognitive, and mental effects on sexual satisfaction in afflicted women. This study aimed to investigate the effect of sexual counseling based on the EX-PLISSIT model on sexual satisfaction in this group of patients.

Materials & Methods: A randomized controlled trial was conducted on 120 married women with SLE in Ahvaz, Iran. Eligible women were randomly assigned to the intervention group (four weeks of psychosexual counseling sessions based on EX-PLISSIT) and the control group, using block randomization with a 1:1 allocation ratio. Before the intervention and eight and twelve weeks after the completion of counseling sessions, the Larson Sexual Satisfaction Questionnaire was administered. Data was analyzed using independent t-tests, paired t-tests, Chi-square test, and repeated measures ANOVA.

Results: There was no significant difference in sexual satisfaction scores between the two groups before the intervention (p₌0.718). Following the intervention, the mean sexual satisfaction score in the intervention group significantly increased (from 93.8±15.59 to 104.5±13.32 after 12 weeks), while a significant decrease was observed in the control group. At the 12-week follow-up, the mean satisfaction in the intervention group was significantly higher than the control group (p<0.0001). Repeated Measures ANOVA confirmed a significant difference in the trend of changes between the two groups over time (p<0.0001).

Conclusion: The results demonstrated that sexual counseling based on the EX-PLISSIT model significantly enhanced sexual satisfaction in married women with SLE compared to the control group. Therefore, this type of counseling is recommended as an effective and simple adjunctive therapeutic service for enhancing sexual satisfaction in women with SLE.

Trial registration: This study has been registered with the Iranian Registry for Clinical Trials

(IRCT20230626058592N2

The effect of the nurse-led ROOTS program and soft skills training on emotional regulation to prevent bullying in high school students in Bandung city

Wed, 06 May 2026 11:08:00 +0000

Background & Aim: Bullying is a significant issue affecting adolescents' mental well-being, with emotional regulation playing a key role in preventing such behavior. In Bandung, high rates of bullying among high school students indicate the need for effective prevention strategies. Nurse-led interventions, combined with soft skills training, offer a promising approach to improving emotional regulation and reducing bullying. This study examined the effect of the Nurse-Led ROOTS Program integrated with Soft Skills Training on emotion regulation among high school students in Bandung City.

Materials & Methods: A class-cluster randomized pretest–posttest control-group study was conducted in July 2025 in two high schools in Bandung, Indonesia. A total of 100 students aged 13-18 years were randomly assigned at the class level to an intervention group (n=50) or a control group (n=50). The intervention was delivered over 8 weeks through nurse-led face-to-face sessions. Emotion regulation was measured using the Emotion Regulation Questionnaire for Children and Adolescents (ERQ-CA) at baseline and post-intervention. Statistical analyses included descriptive statistics, Mann–Whitney U tests, Wilcoxon signed-rank tests, and mixed-effects ANCOVA.

Results: Baseline ERQ-CA scores did not differ significantly between groups (p>0.05). The intervention group showed a significant improvement in total ERQ-CA scores (28.9±4.7 to 36.2±4.3; p< 0.001; r= 0.72), with the largest gains observed in the cognitive reappraisal dimension, whereas the control group showed no significant change (p= 0.218). At posttest, the intervention group had significantly higher ERQ-CA scores than the control group (p< 0.001; r=0.69).

Conclusion: The Nurse-Led ROOTS Program integrated with Soft Skills Training significantly improved emotion regulation among high school students in Bandung. This nurse-facilitated, peer-leadership approach may represent a scalable strategy to strengthen adolescent mental health and support violence prevention in school settings.

Trial registration: ClinicalTrials.gov Identifier: NCT07261397.

Determination of the relationship between nurses' spiritual orientation and compassion fatigue and the factors affecting them: A cross-sectional correlational study

Havva Yeşildere Sağlam, Nurgül Şimal Yavuz — Wed, 06 May 2026 11:12:02 +0000

Background & Aim: In the nursing profession, which is in intense emotional interaction with people, spiritual orientation is thought to be an effective factor on compassion fatigue. This study aimed to identify the factors influencing nurses' spiritual orientation and compassion fatigue, and to examine the relationship between these two variables.

Materials & Methods: This cross-sectional and correlational study was conducted with 346 nurses between July, 2023 and October, 2023. The data were collected through a web-based questionnaire created on Google Forms. The "Introductory Information Form", "Compassion Fatigue Scale" and "Spiritual Orientation Scale" were used to collect the data. Data were analyzed using SPSS 22.0 statistical software.

Results: It was determined that the spiritual orientation scores of the nurses were high (93.180±20.51) and their compassion fatigue levels were moderate (66.110±22.04). Nurses’ spiritual orientation was affected by sex, educational status, working unit, attitude towards profession, and doing the profession with love. Compassion fatigue scores were affected by having children, working unit, working time in the unit, attitude towards profession, and doing the profession with love (p<0.05). No statistically significant relationship was found between nurses' spiritual orientation and compassion fatigue (p>0.05). A weak negative relationship (r=-0.142;p=0.008) was found between nurses' occupational burnout and spiritual orientation levels.

Conclusion: These results suggest that factors influencing compassion fatigue are not limited to spiritual orientation alone, but may include other factors besides it. In this context, it would be important to conduct more comprehensive follow-up studies to examine the relationship between the two concepts and to address the factors that may influence it.

Association between nursing students’ self-reported professionalism and patient safety competencies: A cross-sectional study

Wed, 06 May 2026 11:16:39 +0000

Background & Aim: Nurses play a key role in safeguarding patients, highlighting the need to develop both technical competence and professional identity in nursing students. Although professionalism and patient safety competencies are widely studied, their association remains underexplored, particularly in Central Europe. This study examined the association between Slovak nursing students’ self-reported professionalism and patient safety competencies.

Materials & Methods: A cross-sectional study was conducted among 1,017 nursing students from all nine Slovak public universities offering bachelor’s and master’s programs. Data were collected between February and December 2024 using a questionnaire comprising the Slovak versions of the H-PEPSS and the NPI. Descriptive statistics, the Wilcoxon Signed-Rank test, and Spearman’s correlations were applied.

Results: Significant positive associations were found between professionalism and all patient safety competence domains in both academic and clinical settings (all p≤0.001), with the strongest correlations observed for Culture of safety (academic ρ= 0.347; clinical ρ = 0.400). After adjustment using partial Spearman correlations, Working in teams with other health professionals (academic ρ_partial= 0.112; clinical ρ_partial= 0.132) and Culture of safety (academic ρ_partial=0.108; clinical ρ_partial= 0.143) remained independently associated with professionalism. In the academic setting, Communicating effectively (ρ_partial = 0.068) and Understanding human and environmental factors (ρ_partial= 0.085) also showed small independent associations. Professionalism levels were high (Md= 129.0, IQR= 116.0–142.0).

Conclusion: Professionalism and patient safety competencies are closely interconnected among Slovak nursing students. Students who report stronger professionalism also report higher safety competence. Integrating both more deliberately in nursing education may help support safer practice.

The ABC process of gradual erosion of intimacy among Filipino women: A qualitative study

Michelle Acal Calda — Wed, 06 May 2026 00:00:00 +0000

Background & Aim: Intimate partner relationships are often idealized as sources of love and security; however, for many women, they become contexts of coercion, betrayal, and harm. In the Philippines, intimate partner violence and relational instability remain prevalent, yet the gradual and symbolic processes through which intimacy erodes remain underexplored in nursing and public health. This study explored how Filipino women experience and interpret the gradual erosion of intimacy in their intimate partner relationships.

Materials & Methods: Using a constructivist grounded theory–inspired design, this study involved thirteen Filipino women aged 22-54 who had experienced the dissolution of a significant romantic relationship. In-depth semi-structured interviews were conducted across two analytic phases. Data were analyzed through iterative coding, constant comparison, and memo writing until thematic saturation was reached.

Results: Intimacy erosion was identified as a cumulative, nonlinear process rather than a single rupture. Six interconnected subcategories described this process: (1) abuse and coercive control, (2) behavioral shifts and emotional distancing, (3) cheating and betrayal of trust, (4) disregard and alienation, (5) extended family interference, and (6) frightening and threats to safety. These experiences progressively undermined trust, emotional safety, and commitment, often shifting relationships from endurance to survival-driven separation.

Conclusion: Intimacy erosion among Filipino women reflects a layered process of symbolic loss and relational disempowerment. Early recognition of these patterns is essential. Nurses play a critical role in assessing relational health, validating experiences, and advocating for trauma-informed, culturally responsive interventions that address relational well-being as a public health priority.

The experience of double stigma among LGBT people living with HIV in Lampung, Indonesia: A qualitative study

Wed, 06 May 2026 11:22:55 +0000

Background & Aim: Lesbian, gay, bisexual, and transgender (LGBT) people living with HIV in Indonesia experience double stigma related to HIV status and sexual or gender identity across family, community, and health-care settings. Sociocultural and religious norms in Indonesia reinforce moral judgment and social exclusion, and these pressures reduce psychological well-being, social safety, and continuity of HIV care. Indonesian studies mostly examine HIV-related stigma and LGBT-related stigma separately, so evidence remains limited on how both forms of stigma interact as double stigma.

Materials & Methods: A qualitative study with a descriptive phenomenological design used purposive sampling to recruit 18 LGBT people living with HIV from community-based settings in Lampung, Indonesia. Data were collected using semi-structured interviews between August and October 2025. The researchers conducted in-depth face-to-face interviews and analyzed manually using Colaizzi’s method to identify core themes of lived experience.

Results: The analysis identified three main themes and eight interrelated subthemes reflecting participants’ experiences of dual stigma. The themes included Identity Struggles Under HIV and LGBT Stigma, Family Responses to HIV and LGBT Identity, and Community Reactions to HIV and LGBT Identity.

Conclusion: Individuals living with HIV from LGBT backgrounds experience intersecting forms of stigma that affect their identity, family dynamics, and community participation. Addressing both HIV-related and identity-based stigma is essential to reduce psychosocial distress and promote inclusive support systems. These findings underscore the urgent need for family- and community-engaged interventions to safeguard holistic well-being and sustain HIV care among LGBT people living with HIV.