examples of nursing research articles

• For Students
• For Faculty
• Interlibrary Loan
• Request an Item from Everett Library
• Study Rooms & Labs
• Archives & Special Collections
• Accessibility Guide
• Citing Your Sources
• Off-Campus Access
• Online Tutorials
• Library 101
• Library Staff
• Library Hours
• Library Diversity Statement
• Friends of the Library
• History of Everett Library
• Give to the Library
• Library Mission & Vision
• Library Policies

Service Alert

• Nursing Databases
• APA Tutorial
• EBP - Evidence Based Practice and PICO
• Journal Search
• Nursing Websites
• Video Tutorials
• Digital Literacy Sites

Articles from Ovid Database

Abnf articles.

• Journal of Midwifery and Women's Health
• Link to Nursing Research (journal) This journal includes nursing research and has some quantitative studies.
• AJN, American Journal of Nursing
• Increasing Access to Diabetes Education in Rural Alabama Through Telehealth
• Evaluating the Impact of Smartphones on Nursing Workflow: Lessons Learned
• Validity of the Montreal Cognitive Assessment Screener in Adolescents and Young Adults With and Without Congenital Heart Disease
• Pharmacogenetics of Ketamine-Induced Emergence Phenomena
• Pressure Pain Phenotypes in Women Before Breast Cancer Treatmen
• Efficacy of a Breastfeeding Pain SelfManagement Intervention: A Pilot Randomized Controlled Tria
• Stress and Health in Nursing Students The Nurse Engagement and Wellness Study
• The Efficacy and Safety of an RN-Driven Ketamine Protocol for Adjunctive Analgesia During Burn Wound Care
• Potassium Channel Candidate Genes Predict the Development of Secondary Lymphedema Following Breast Cancer Surgery
• Social Support Is Inversely Associated With Sleep Disturbance, Inflammation, and Pain Severity in Chronic Low Back Pain.
• Effect of a Nurse-Led Community Health Worker Intervention on Latent Tuberculosis Medication Completion Among Homeless Adults
• Poor Sleep Predicts Increased Pain Perception Among Adults With Mild Cognitive Impairment
• Feasibility, Acceptability, and Preliminary Effects of “Mindful Moms” A Mindful Physical Activity Intervention for Pregnant Women with Depression
• Associations Among Nitric Oxide and Enkephalinases With Fibromyalgia Symptoms
• Prescribed Walking for Glycemic Control and Symptom Management in Patients Without Diabetes Undergoing Chemotherapy
• Dysmenorrhea Symptom-Based Phenotypes A Replication and Extension Study
• Influence of Oxidative Stress-Related Genes on Susceptibility to Fibromyalgia
• ABNF journal link
• Cardiovascular Diseases in African-American Women: An Assessment of Awareness
• Document links
• << Previous: Digital Literacy Sites
• Last Updated: Feb 27, 2024 4:29 PM
• URL: https://library.queens.edu/nursing

University of Houston Libraries

Nursing resources.

• About This Guide
• Scholarly Articles
• Books and eBooks
• Study Resources
• Data and Statistics
• Web Resources
• Health Assessment Videos
• Citation Resources

This page provides links to databases and journals where you can find articles and clinical information to help you with your research.

Recommended Resources

• Nursing & Allied Health Databases

Citation Indexes

Evidence-Based Practice Databases

Biomedicine Databases

• Dissertations & Theses Databases

Clinical Tools

Nursing & Allied Health Databases

• PubMed This link opens in a new window PubMed® comprises more than 30 million citations for biomedical literature from MEDLINE, life science journals, and online books.
• CINAHL Complete This link opens in a new window This database provides access to health science literature related to nursing and allied health disciplines. In addition, it includes standards of practice and evidence-based care guidelines.
• EMBASE This link opens in a new window EMBASE is a major biomedical and pharmaceutical database indexing over 3,500 international journals in the following fields: drug research, pharmacology, pharmaceutics, toxicology, clinical and experimental human medicine, health policy and management, public health, occupational health, environmental health, drug dependence and abuse, psychiatry, forensic medicine, and biomedical engineering/instrumentation. There is selective coverage for nursing, dentistry, veterinary medicine, psychology, and alternative medicine.

• Journals@Ovid This link opens in a new window The database aggregates hundreds of scientific, technical, and medical journals from over 50 publishers and societies, with each journal available by individual subscription. Includes access and searching of all the bibliographic citations, references, and abstracts in the database as well as to the full text of select journals.
• Ovid Nursing Database This link opens in a new window Exclusive collection of top nursing journals which are used by nurses, nursing students and health professionals around the world on a daily basis.
• See all nursing databases here.

Health science research is often multidisciplinary. Below is a list of multidisciplinary databases to start you in the right path. You can also use these databases to conduct basic searches to 'scope' out a subject; quickly find seminal articles; and conduct bibliometrics research. 

Key Citation Indexes

• Web of Science This link opens in a new window Web of Science is a comprehensive research platform. Journal articles, patents, websites, conference proceedings, Open Access material—all can be accessed through one interface, using a variety of powerful search and analysis tools. Web of Science Core Collection is a painstakingly selected, actively curated database of the journals that researchers themselves have judged to be the most important and useful in their fields

Regional Indexes

• Global Index Medicus (GIM) Regional indexes for global health research provided by the World Health Organization. Consists of 5 regional indices (listed below) and contains literature published from low- and middle- income countries.
• African Index Medicus (AIM) International index to health information published in or related to Africa.
• LILACS: Latin American and Caribbean Health Sciences Literature Covers literature related to the health sciences and has been published in countries of Latin America and the Caribbean since 1982.
• Index Medicus for the Eastern Mediterranean Region (IMEMR) IMEMR comprises about 256,078 citations for health and biomedical sciences literature published in 782 peer-reviewed journals from 20 countries in the Region.
• Index Medicus for the South-East Asian Region (IMSEAR) IMSEAR is an archive of selected publications in health sciences in the WHO South-East Asia Region.
• Western Pacific Region Index Medicus (WPRIM) WPRIM is the regional bibliographic index of medical and health journals published by the Member States of the Western Pacific Region.
• PubMed Clinical Queries PubMed Clinical Queries allows you to quickly and easily search for relevant clinical literature on etiology, prognosis, diagnosis and therapy of diseases and diagnostics. PubMed Clinical Queries is designed to filter one search by three clinical research areas: Clinical Study Categories, Systematic Reviews, and Medical Genetics.
• MEDLINE with Full Text This link opens in a new window Full-text database providing access to top-tier biomedical and health journals.

Dissertations & Theses Databases

• DynaMed This link opens in a new window DynaMed is a clinical reference tool of more than 3000 topics designed for physicians and health care professionals for use primarily at the point-of-care. DynaMed is updated daily and monitors the content of over 500 medical journal and systemic evidence review databases.

• UpToDate This link opens in a new window A point-of-care clinical resource. Useful for quick information about conditions, drugs, etc.

Top Nursing Journals

Top 5 nursing journals with the highest 5-year impact factor rankings in Journal Citation Reports. If the full text is available from the UH Libraries, the title is in red (click to access).

• More Nursing Journals

What is a library database?

Your instructor or subject librarian may throw around the term "library database" a lot, but what exactly do they mean? This video from the University of Houston Libraries explains the term and how you can use databases for research.

Transcript available through YouTube .

Remote Access

You can access UH Libraries' online resources from anywhere!

To access online resources (e.g. databases, articles) while off campus, you will be asked to log in with your  CourgarNet account . Once you log in, you will be redirected to the online resource you selected. You must be a current student, faculty, or staff.

If you do not know your CougarNet account information, then please contact UIT Support Center at:

713-743-1411

or  chat with a support representative .

If you have any difficulties accessing UH Libraries' online resources, please use  this form  to let us know!

• << Previous: About This Guide
• Next: Books and eBooks >>

Medical & Health Sciences Librarian

Health & Medicine Databases @ UH Libraries

Browse our best resources-organized by subject-available through UH Libraries. Databases are accessible to UH-affiliated users.

• Communication Sciences & Disorders Databases
• Health & Human Performance Databases
• Medicine Databases
• Nutrition Databases
• Pharmacy Databases
• Psychology Databases
• Social Work Databases

Search for Journals

Search by title or ISBN to see if UH Libraries has access to a particular journal. Journal search.

• Last Updated: Aug 19, 2024 11:50 AM
• URL: https://guides.lib.uh.edu/nursing

Best Nursing Research Topics for Students

What is a nursing research paper.

• What They Include
• Choosing a Topic
• Best Nursing Research Topics
• Research Paper Writing Tips

Writing a research paper is a massive task that involves careful organization, critical analysis, and a lot of time. Some nursing students are natural writers, while others struggle to select a nursing research topic, let alone write about it.

If you're a nursing student who dreads writing research papers, this article may help ease your anxiety. We'll cover everything you need to know about writing nursing school research papers and the top topics for nursing research.  

Continue reading to make your paper-writing jitters a thing of the past.

Popular Online Master of Science in Nursing (MSN) Programs

GCU's College of Nursing and Health Care Professions has a nearly 35-year tradition of preparing students to fill evolving healthcare roles as highly qualified professionals. GCU offers a full spectrum of nursing degrees, from a pre-licensure BSN degree to a Doctor of Nursing Practice (DNP) program.

Enrollment: Nationwide

• MSN - Family NP
• MSN - Adult Gerontology Acute Care NP
• MSN - Nursing Education
• MSN - Health Informatics
• MSN - Public Health Nursing
• MSN - Health Care Quality & Patient Safety
• MBA & MSN - Nursing Leadership in Health Care Systems
• See more GCU nursing programs

WGU's award-winning online programs are created to help you succeed while graduating faster and with less debt. WGU is a CCNE accredited, nonprofit university offering nursing bachelor's and master's degrees.

• BSN-to-MSN - Family NP
• BSN-to-MSN - Psychiatric Mental Health NP
• BSN-to-MSN - Nursing Education
• RN-to-MSN - Nursing Education
• RN-to-MSN - Nursing Leadership & Management

Enrollment: Nationwide, excluding NY, RI and CT. Certain programs have additional state restrictions. Check with Walden for details.

• MSN - Psychiatric-Mental Health NP
• MSN - Adult/Gerontology Acute Care NP
• MSN - Adult/Gerontology Primary Care NP
• MSN - Pediatric NP - Primary Care
• MSN - Nursing Informatics

As a working RN, you need a flexible, transfer-friendly program to help you save time and money as you take the next step in your nursing career. In our CCNE-accredited4 RN to BSN program, you can transfer in up to 134 credits—which is nearly 75% of program requirements. Your transfer credits can be reviewed in one business day (on average).

Enrollment: FL

• MSN - Adult-Gerontology NP - Primary Care
• MSN - Nursing Leadership & Admin
• MSN - Healthcare Tech, Simulation & Informatics
• See more Rasmussen nursing programs

A nursing research paper is a work of academic writing composed by a nurse or nursing student. The paper may present information on a specific topic or answer a question.

During LPN/LVN and RN programs, most papers you write focus on learning to use research databases, evaluate appropriate resources, and format your writing with APA style. You'll then synthesize your research information to answer a question or analyze a topic.

BSN , MSN , Ph.D., and DNP programs also write nursing research papers. Students in these programs may also participate in conducting original research studies.

Writing papers during your academic program improves and develops many skills, including the ability to:

• Select nursing topics for research
• Conduct effective research
• Analyze published academic literature
• Format and cite sources
• Synthesize data
• Organize and articulate findings

About Nursing Research Papers

When do nursing students write research papers.

You may need to write a research paper for any of the nursing courses you take. Research papers help develop critical thinking and communication skills. They allow you to learn how to conduct research and critically review publications.

That said, not every class will require in-depth, 10-20-page papers. The more advanced your degree path, the more you can expect to write and conduct research. If you're in an associate or bachelor's program, you'll probably write a few papers each semester or term.

Do Nursing Students Conduct Original Research?

Most of the time, you won't be designing, conducting, and evaluating new research. Instead, your projects will focus on learning the research process and the scientific method. You'll achieve these objectives by evaluating existing nursing literature and sources and defending a thesis.

However, many nursing faculty members do conduct original research. So, you may get opportunities to participate in, and publish, research articles.

Example Research Project Scenario:

In your maternal child nursing class, the professor assigns the class a research paper regarding developmentally appropriate nursing interventions for the pediatric population. While that may sound specific, you have almost endless opportunities to narrow down the focus of your writing. 

You could choose pain intervention measures in toddlers. Conversely, you can research the effects of prolonged hospitalization on adolescents' social-emotional development.

What Does a Nursing Research Paper Include?

Your professor should provide a thorough guideline of the scope of the paper. In general, an undergraduate nursing research paper will consist of:

Introduction : A brief overview of the research question/thesis statement your paper will discuss. You can include why the topic is relevant.

Body : This section presents your research findings and allows you to synthesize the information and data you collected. You'll have a chance to articulate your evaluation and answer your research question. The length of this section depends on your assignment.

Conclusion : A brief review of the information and analysis you presented throughout the body of the paper. This section is a recap of your paper and another chance to reassert your thesis.

The best advice is to follow your instructor's rubric and guidelines. Remember to ask for help whenever needed, and avoid overcomplicating the assignment!

How to Choose a Nursing Research Topic

The sheer volume of prospective nursing research topics can become overwhelming for students. Additionally, you may get the misconception that all the 'good' research ideas are exhausted. However, a personal approach may help you narrow down a research topic and find a unique angle.

Writing your research paper about a topic you value or connect with makes the task easier. Additionally, you should consider the material's breadth. Topics with plenty of existing literature will make developing a research question and thesis smoother.

Finally, feel free to shift gears if necessary, especially if you're still early in the research process. If you start down one path and have trouble finding published information, ask your professor if you can choose another topic.

The Best Research Topics for Nursing Students

You have endless subject choices for nursing research papers. This non-exhaustive list just scratches the surface of some of the best nursing research topics.

1. Clinical Nursing Research Topics

• Analyze the use of telehealth/virtual nursing to reduce inpatient nurse duties.
• Discuss the impact of evidence-based respiratory interventions on patient outcomes in critical care settings.
• Explore the effectiveness of pain management protocols in pediatric patients.

2. Community Health Nursing Research Topics

• Assess the impact of nurse-led diabetes education in Type II Diabetics.
• Analyze the relationship between socioeconomic status and access to healthcare services.

3. Nurse Education Research Topics

• Review the effectiveness of simulation-based learning to improve nursing students' clinical skills.
• Identify methods that best prepare pre-licensure students for clinical practice.
• Investigate factors that influence nurses to pursue advanced degrees.
• Evaluate education methods that enhance cultural competence among nurses.
• Describe the role of mindfulness interventions in reducing stress and burnout among nurses.

4. Mental Health Nursing Research Topics

• Explore patient outcomes related to nurse staffing levels in acute behavioral health settings.
• Assess the effectiveness of mental health education among emergency room nurses .
• Explore de-escalation techniques that result in improved patient outcomes.
• Review the effectiveness of therapeutic communication in improving patient outcomes.

5. Pediatric Nursing Research Topics

• Assess the impact of parental involvement in pediatric asthma treatment adherence.
• Explore challenges related to chronic illness management in pediatric patients.
• Review the role of play therapy and other therapeutic interventions that alleviate anxiety among hospitalized children.

6. The Nursing Profession Research Topics

• Analyze the effects of short staffing on nurse burnout .
• Evaluate factors that facilitate resiliency among nursing professionals.
• Examine predictors of nurse dissatisfaction and burnout.
• Posit how nursing theories influence modern nursing practice.

Tips for Writing a Nursing Research Paper

The best nursing research advice we can provide is to follow your professor's rubric and instructions. However, here are a few study tips for nursing students to make paper writing less painful:

Avoid procrastination: Everyone says it, but few follow this advice. You can significantly lower your stress levels if you avoid procrastinating and start working on your project immediately.

Plan Ahead: Break down the writing process into smaller sections, especially if it seems overwhelming. Give yourself time for each step in the process.

Research: Use your resources and ask for help from the librarian or instructor. The rest should come together quickly once you find high-quality studies to analyze.

Outline: Create an outline to help you organize your thoughts. Then, you can plug in information throughout the research process. 

Clear Language: Use plain language as much as possible to get your point across. Jargon is inevitable when writing academic nursing papers, but keep it to a minimum.

Cite Properly: Accurately cite all sources using the appropriate citation style. Nursing research papers will almost always implement APA style. Check out the resources below for some excellent reference management options.

Revise and Edit: Once you finish your first draft, put it away for one to two hours or, preferably, a whole day. Once you've placed some space between you and your paper, read through and edit for clarity, coherence, and grammatical errors. Reading your essay out loud is an excellent way to check for the 'flow' of the paper.

Helpful Nursing Research Writing Resources:

Purdue OWL (Online writing lab) has a robust APA guide covering everything you need about APA style and rules.

Grammarly helps you edit grammar, spelling, and punctuation. Upgrading to a paid plan will get you plagiarism detection, formatting, and engagement suggestions. This tool is excellent to help you simplify complicated sentences.

Mendeley is a free reference management software. It stores, organizes, and cites references. It has a Microsoft plug-in that inserts and correctly formats APA citations.

Don't let nursing research papers scare you away from starting nursing school or furthering your education. Their purpose is to develop skills you'll need to be an effective nurse: critical thinking, communication, and the ability to review published information critically.

Choose a great topic and follow your teacher's instructions; you'll finish that paper in no time.

Joleen Sams is a certified Family Nurse Practitioner based in the Kansas City metro area. During her 10-year RN career, Joleen worked in NICU, inpatient pediatrics, and regulatory compliance. Since graduating with her MSN-FNP in 2019, she has worked in urgent care and nursing administration. Connect with Joleen on LinkedIn or see more of her writing on her website.

Plus, get exclusive access to discounts for nurses, stay informed on the latest nurse news, and learn how to take the next steps in your career.

By clicking “Join Now”, you agree to receive email newsletters and special offers from Nurse.org. You may unsubscribe at any time by using the unsubscribe link, found at the bottom of every email.

• Privacy Policy

Home » 500+ Nursing Research Topic Ideas

500+ Nursing Research Topic Ideas

Table of Contents

Nursing research plays a crucial role in advancing healthcare and improving patient outcomes. As a field that is constantly evolving, there is a great need for new ideas and innovative approaches to address the challenges faced by nurses in their day-to-day practice. In this article, we will explore some exciting nursing research topic ideas that can help guide the development of new studies and inspire nurses to make meaningful contributions to the field. From exploring the impact of technology on nursing practice to investigating the effectiveness of alternative therapies, there is no shortage of interesting and important topics to explore in the world of nursing research.

Nursing Research Topic Ideas

Nursing Research Topic Ideas are as follows:

• The effectiveness of telemedicine in providing nursing care.
• The relationship between nurse staffing levels and patient outcomes.
• The impact of nurse-led interventions on medication adherence in chronic disease management.
• The effectiveness of mindfulness-based interventions in reducing burnout among nurses.
• The influence of cultural competence on patient satisfaction with nursing care.
• The effects of virtual reality simulation training on nursing students’ clinical competencies.
• The impact of nurse practitioner-led care on chronic disease management in primary care.
• The effectiveness of nurse-led discharge planning on patient outcomes.
• The influence of nurse-to-patient ratios on the incidence of hospital-acquired infections.
• The effectiveness of nurse-led health coaching on lifestyle modifications in patients with chronic diseases.
• The effects of interprofessional collaboration on patient outcomes in acute care settings.
• The impact of nurse-led patient education on medication adherence in older adults.
• The relationship between nurse work environment and patient safety outcomes.
• The effectiveness of nurse-led cognitive-behavioral therapy on anxiety and depression in patients with chronic pain.
• The influence of nurse staffing levels on patient satisfaction with nursing care.
• The effects of a nurse-led palliative care program on quality of life for patients with terminal illnesses.
• The impact of nurse-led group therapy on social support and quality of life in patients with chronic illnesses.
• The effectiveness of nurse-led motivational interviewing on smoking cessation in patients with mental health disorders.
• The relationship between nurse staffing levels and patient length of stay in acute care settings.
• The effects of nurse-led behavioral interventions on weight loss and management in patients with obesity.
• The influence of nurse-led interventions on self-care management in patients with heart failure.
• The effectiveness of nurse-led mindfulness-based stress reduction programs on caregiver burden in family caregivers of patients with dementia.
• The impact of nurse-led interventions on pain management in patients with sickle cell disease.
• The relationship between nurse staffing levels and patient readmission rates.
• The effects of nurse-led motivational interviewing on medication adherence in patients with hypertension.
• The influence of nurse-led telehealth programs on glycemic control in patients with diabetes.
• The effectiveness of nurse-led interventions on patient outcomes in postoperative care.
• The impact of nurse-led interventions on patient satisfaction with hospital food services.
• The relationship between nurse staffing levels and patient falls in acute care settings.
• The effects of nurse-led interventions on patient anxiety and stress in the preoperative period.
• The influence of nurse-led interventions on wound healing in patients with chronic ulcers.
• The effectiveness of nurse-led interventions on postpartum depression in new mothers.
• The impact of nurse-led transitional care on hospital readmissions in older adults.
• The relationship between nurse work environment and nurse retention.
• The effects of nurse-led music therapy on anxiety and depression in patients with dementia.
• The influence of nurse-led mindfulness-based interventions on sleep quality in patients with insomnia.
• The effectiveness of nurse-led interventions on symptom management in patients with cancer.
• The impact of nurse-led interventions on patient satisfaction with care coordination.
• The relationship between nurse staffing levels and patient mortality in critical care settings.
• The effects of nurse-led interventions on patient outcomes in end-of-life care.
• The impact of mindfulness meditation on the mental health of nursing students.
• The effect of patient education on the adherence to medication regimens in older adults.
• The role of nurse-led interventions in improving physical activity levels in sedentary individuals.
• The efficacy of telehealth in managing chronic conditions in rural communities.
• The effect of music therapy on anxiety and pain in cancer patients undergoing chemotherapy.
• The impact of cultural competency training on nursing students’ attitudes towards diverse patient populations.
• The effectiveness of peer support interventions in reducing readmission rates among individuals with heart failure.
• The use of virtual reality in nursing education to improve clinical decision-making skills.
• The role of family caregivers in end-of-life care decision making.
• The impact of nurse-led discharge planning on hospital readmission rates.
• The effect of a structured communication tool on interdisciplinary communication and collaboration in acute care settings.
• The role of nurses in promoting vaccination uptake in underserved communities.
• The impact of early mobilization on functional outcomes in critically ill patients.
• The effectiveness of an interdisciplinary team approach in managing chronic pain in older adults.
• The role of nursing in addressing the opioid epidemic.
• The effect of a nurse-led weight management program on obesity-related health outcomes.
• The impact of technology-based interventions on medication adherence in individuals with psychiatric disorders.
• The effectiveness of a nursing-led smoking cessation program in hospitalized patients.
• The role of nurses in promoting healthy sleep habits in children.
• The effect of a nurse-led intervention on caregiver burden in family caregivers of stroke survivors.
• The impact of nurse-led motivational interviewing on lifestyle behavior change in individuals with chronic conditions.
• The effectiveness of nurse-led care transitions in reducing hospital readmissions.
• The role of nursing in promoting advance care planning among older adults.
• The impact of a nurse-led education program on self-care management in individuals with diabetes.
• The effect of nurse-led education on medication adherence in individuals with hypertension.
• The role of nurses in identifying and addressing social determinants of health in underserved populations.
• The impact of a nurse-led exercise program on physical function and quality of life in older adults.
• The effectiveness of nurse-led education on smoking cessation in pregnant women.
• The role of nurses in promoting health literacy among diverse patient populations.
• The effect of a nurse-led fall prevention program on fall-related injuries in older adults.
• The impact of a nurse-led education program on medication safety in hospitalized patients.
• The effectiveness of a nurse-led mindfulness-based stress reduction program in individuals with chronic pain.
• The role of nurses in managing the care of individuals with multiple chronic conditions.
• The effect of nurse-led patient education on the prevention of hospital-acquired infections.
• The impact of nurse-led coaching on self-management in individuals with heart failure.
• The effectiveness of nurse-led care coordination in improving care transitions for individuals with complex medical needs.
• The role of nurses in promoting healthy eating habits in children and adolescents.
• The effect of a nurse-led symptom management program on quality of life in individuals with advanced cancer.
• The impact of a nurse-led program on the self-efficacy of individuals with chronic conditions.
• The role of nurses in promoting sexual health education among adolescents.
• The effect of a nurse-led peer support program on mental health outcomes in individuals with substance use disorders.
• The impact of nurse-led interventions on reducing hospital-acquired pressure ulcers.
• The effectiveness of nurse-led education on nutrition and physical activity in pregnant women.
• The role of nurses in addressing health disparities in marginalized communities.
• The effect of nurse-led mindfulness interventions on the mental health of healthcare providers.
• The impact of a nurse-led program on medication adherence and quality of life in individuals with HIV/AIDS.
• The effectiveness of nurse-led interventions in reducing healthcare-associated infections in long-term care facilities.
• The role of nurses in promoting palliative care for individuals with advanced dementia.
• The effect of a nurse-led exercise program on cognitive function in older adults with mild cognitive impairment.
• The impact of nurse-led interventions on reducing falls in hospitalized older adults.
• The effectiveness of nurse-led interventions on reducing medication errors in hospitalized patients.
• The role of nurses in promoting sexual and reproductive health among LGBTQ+ individuals.
• The effect of nurse-led interventions on improving medication adherence in individuals with mental health conditions.
• The impact of nurse-led coaching on self-care management in individuals with chronic kidney disease.
• The effectiveness of nurse-led interventions on improving sleep quality in individuals with chronic pain.
• The role of nurses in promoting oral health in individuals with intellectual disabilities.
• The effect of nurse-led interventions on reducing the incidence of hospital-acquired delirium.
• The impact of a nurse-led program on the self-care management of individuals with heart failure.
• The effectiveness of nurse-led education on self-care management in individuals with chronic obstructive pulmonary disease.
• The role of nurses in promoting healthy lifestyle behaviors in adolescents with type 1 diabetes.
• The effect of a nurse-led program on the prevention of central line-associated bloodstream infections.
• The impact of nurse-led interventions on reducing healthcare costs for individuals with chronic conditions.
• The effectiveness of nurse-led interventions on improving the quality of life of individuals with chronic obstructive pulmonary disease.
• The role of nurses in promoting early detection and management of sepsis in hospitalized patients.
• The effect of nurse-led education on promoting breastfeeding among new mothers.
• The impact of a nurse-led program on the management of chronic pain in individuals with sickle cell disease.
• The effectiveness of nurse-led interventions on improving medication adherence in individuals with heart failure.
• The role of nurses in promoting health literacy and patient empowerment among individuals with low health literacy.
• The effect of a nurse-led program on the prevention of catheter-associated urinary tract infections.
• The impact of nurse-led interventions on reducing readmission rates in individuals with heart failure.
• The effectiveness of nurse-led interventions on improving medication adherence in individuals with chronic kidney disease.
• The role of nurses in promoting self-care management among individuals with depression.
• The effect of a nurse-led program on improving the quality of life of individuals with spinal cord injuries.
• The impact of nurse-led interventions on reducing medication errors in outpatient settings.
• The effectiveness of nurse-led education on promoting healthy lifestyle behaviors among older adults with chronic conditions.
• The role of nurses in promoting self-management among individuals with schizophrenia.
• The effect of nurse-led interventions on improving mental health outcomes in individuals with chronic pain.
• The impact of nurse-led interventions on reducing hospital length of stay for individuals with heart failure.
• The effectiveness of nurse-led interventions on improving the quality of life of individuals with chronic hepatitis C.
• The role of nurses in promoting pain management strategies for patients with sickle cell disease.
• The effect of a nurse-led education program on improving the quality of life for patients with chronic obstructive pulmonary disease and their caregivers.
• The impact of nurse-led interventions on reducing healthcare-associated infections in the neonatal intensive care unit.
• The effectiveness of nurse-led interventions on improving self-care management and quality of life for patients with chronic kidney disease.
• The role of nurses in promoting patient safety through effective communication strategies.
• The effect of a nurse-led program on reducing readmission rates in patients with congestive heart failure.
• The impact of nurse-led interventions on improving end-of-life care for patients with advanced cancer.
• The effectiveness of nurse-led education on improving the nutritional status of patients with diabetes.
• The role of nurses in promoting evidence-based practices for the prevention and treatment of pressure ulcers.
• The effect of nurse-led interventions on reducing anxiety and depression in patients with chronic pain.
• The impact of nurse-led interventions on reducing medication errors in the emergency department.
• The effectiveness of nurse-led education on promoting tobacco cessation among patients with respiratory diseases.
• The role of nurses in promoting culturally competent care for patients from diverse backgrounds.
• The effect of a nurse-led program on improving sleep quality and quantity for patients with sleep disorders.
• The impact of nurse-led interventions on improving self-management and quality of life for patients with heart failure.
• The effectiveness of nurse-led interventions on reducing the incidence of ventilator-associated pneumonia in critically ill patients.
• The role of nurses in promoting early recognition and management of sepsis in the emergency department.
• The effect of nurse-led education on improving patient satisfaction with pain management.
• The impact of nurse-led interventions on reducing healthcare costs for patients with chronic conditions.
• The effectiveness of nurse-led education on promoting adherence to medication regimens among patients with HIV/AIDS.
• The role of nurses in promoting patient-centered care for patients with chronic diseases.
• The effect of a nurse-led program on improving pain management in patients with dementia.
• The impact of nurse-led interventions on reducing the incidence of falls in hospitalized patients.
• The effectiveness of nurse-led interventions on improving wound healing in patients with chronic wounds.
• The role of nurses in promoting early detection and management of delirium in hospitalized patients.
• The effect of nurse-led education on improving patient outcomes after cardiac surgery.
• The impact of nurse-led interventions on reducing healthcare-associated infections in long-term care facilities.
• The effectiveness of nurse-led education on promoting healthy eating behaviors among adolescents with obesity.
• The role of nurses in promoting patient safety through effective hand hygiene practices.
• The effect of a nurse-led program on improving functional status and quality of life for patients with Parkinson’s disease.
• The impact of nurse-led interventions on reducing readmission rates in patients with chronic obstructive pulmonary disease.
• The effectiveness of nurse-led interventions on improving patient outcomes after hip replacement surgery.
• The role of nurses in promoting effective communication between patients and healthcare providers.
• The effect of nurse-led education on improving medication management in patients with multiple chronic conditions.
• The impact of nurse-led interventions on reducing healthcare costs for patients with mental health conditions.
• The effectiveness of nurse-led education on promoting physical activity among patients with cardiovascular diseases.
• The role of nurses in promoting patient-centered care for patients with substance use disorders.
• The effect of a nurse-led program on improving self-care management and quality of life for patients with asthma.
• The impact of nurse-led interventions on reducing the incidence of central line-associated bloodstream infections in the intensive care unit.
• The role of nurses in promoting resilience among healthcare providers during the COVID-19 pandemic.
• The effect of nurse-led interventions on improving adherence to tuberculosis medication.
• The impact of nurse-led programs on improving end-of-life care in hospice settings.
• The effectiveness of nurse-led interventions on reducing the incidence of ventilator-associated pneumonia.
• The role of nurses in promoting healthy sleep habits in hospitalized children.
• The effect of nurse-led education on improving wound care management in individuals with diabetes.
• The impact of a nurse-led program on improving patient satisfaction in emergency departments.
• The effectiveness of nurse-led interventions on reducing medication errors in pediatric settings.
• The role of nurses in promoting healthy aging among older adults living in rural communities.
• The effect of nurse-led interventions on improving oral hygiene in individuals with cancer undergoing chemotherapy.
• The impact of nurse-led interventions on reducing the incidence of hospital-acquired infections in neonatal intensive care units.
• The effectiveness of nurse-led education on improving pain management in individuals with sickle cell disease.
• The role of nurses in promoting mental health awareness and support in the workplace.
• The effect of nurse-led interventions on improving hand hygiene compliance among healthcare providers.
• The impact of a nurse-led program on improving self-management in individuals with type 2 diabetes.
• The effectiveness of nurse-led interventions on reducing readmission rates in individuals with chronic obstructive pulmonary disease.
• The role of nurses in promoting healthy lifestyle behaviors among individuals with HIV/AIDS.
• The effect of nurse-led education on improving medication adherence in individuals with schizophrenia.
• The impact of nurse-led interventions on reducing falls in older adults living in long-term care facilities.
• The effectiveness of nurse-led programs on improving communication and teamwork in healthcare settings.
• The role of nurses in promoting healthy eating habits among adolescents with obesity.
• The effect of nurse-led interventions on improving pain management in individuals with cancer.
• The impact of a nurse-led program on improving self-management in individuals with heart failure.
• The effectiveness of nurse-led education on promoting healthy sexuality in individuals with disabilities.
• The role of nurses in promoting mental health among homeless populations.
• The effect of nurse-led interventions on improving self-care management in individuals with multiple sclerosis.
• The impact of nurse-led interventions on reducing medication errors in geriatric settings.
• The effectiveness of nurse-led programs on improving patient outcomes in acute care settings.
• The role of nurses in promoting healthy coping mechanisms among individuals with chronic pain.
• The effect of nurse-led education on improving wound care management in individuals with venous leg ulcers.
• The impact of nurse-led interventions on reducing hospital readmission rates in individuals with chronic kidney disease.
• The effectiveness of nurse-led programs on improving end-of-life care in nursing homes.
• The role of nurses in promoting safe medication administration in pediatric settings.
• The effect of nurse-led interventions on improving sleep quality in individuals with depression.
• The impact of nurse-led programs on improving pain management in individuals with fibromyalgia.
• The effectiveness of nurse-led education on improving communication skills among healthcare providers.
• The role of nurses in promoting healthy lifestyle behaviors among individuals with mental health conditions.
• The effect of nurse-led interventions on improving self-care management in individuals with chronic heart failure.
• The impact of nurse-led programs on improving patient outcomes in rehabilitation settings.
• The effectiveness of nurse-led education on promoting healthy habits among individuals with chronic obstructive pulmonary disease.

Interesting Nursing Research Topic Ideas

• The impact of nurse-led health education on the management of chronic diseases in low-income communities.
• The effectiveness of using telehealth technology to monitor and manage patients with mental health disorders.
• The role of nursing in promoting ethical and responsible use of AI in healthcare.
• The impact of the COVID-19 pandemic on the mental health of frontline nurses.
• The effectiveness of mindfulness-based stress reduction techniques on reducing burnout among nurses.
• Exploring the experiences of male nurses in a predominantly female profession.
• The impact of nurse-patient communication on patient satisfaction and clinical outcomes.
• The effectiveness of music therapy in reducing anxiety and pain among patients in intensive care units.
• The impact of social media on nursing education and professional development.
• The impact of nurse-to-patient ratios on patient outcomes and nurse satisfaction.
• The use of simulation-based training in nursing education to improve clinical competency.
• The effectiveness of nurse-led interventions in reducing hospital readmissions.
• The impact of interprofessional collaboration on patient safety and quality of care.
• The effectiveness of nurse-led smoking cessation interventions in promoting smoking cessation among patients.
• The role of nurses in promoting sexual and reproductive health among adolescent girls.
• The effectiveness of nurse-led interventions in improving medication adherence among patients with chronic diseases.
• The impact of cultural competence training on nursing practice and patient outcomes.
• The effectiveness of mindfulness-based interventions in improving sleep quality among shift-working nurses.
• The role of nurses in promoting vaccination uptake among underserved populations.
• The impact of nurse-led interventions on improving self-care behaviors among patients with heart failure.
• The effectiveness of nurse-led interventions in improving pain management among cancer patients.
• The impact of nurse-led care coordination on improving care transitions for patients with multiple chronic conditions.
• The role of nurses in promoting healthy aging and preventing age-related diseases.
• The effectiveness of peer mentoring programs in promoting professional development among novice nurses.
• The impact of nurse-led palliative care interventions on improving end-of-life care for patients with terminal illnesses.
• The effectiveness of nurse-led interventions in reducing falls among elderly patients in long-term care facilities.
• The role of nurses in promoting healthy lifestyles and preventing chronic diseases in the community.
• The impact of nurse-led discharge planning on reducing hospital readmissions and improving patient outcomes.
• The effectiveness of nurse-led interventions in improving glycemic control among patients with diabetes.
• The role of nurses in promoting mental health and wellbeing among healthcare professionals.
• The impact of nurse-led interventions in promoting self-management behaviors among patients with chronic obstructive pulmonary disease.
• The effectiveness of nurse-led motivational interviewing in promoting physical activity among sedentary patients.
• The role of nurses in promoting safe medication use and preventing medication errors.
• The impact of nurse-led interventions in improving nutritional status among patients with malnutrition.
• The effectiveness of nurse-led interventions in promoting breastfeeding among new mothers.
• The role of nurses in promoting healthy work environments and preventing workplace violence.
• The impact of nurse-led interventions in promoting early detection and management of hypertension.
• The effectiveness of nurse-led interventions in improving adherence to antiretroviral therapy among patients with HIV.
• The role of nurses in promoting evidence-based practice and improving patient outcomes.
• The impact of nurse-led interventions in promoting smoking cessation among pregnant women.
• The effectiveness of nurse-led interventions in improving sleep quality among patients with obstructive sleep apnea.
• The role of nurses in promoting patient safety and preventing medical errors.
• The impact of nurse-led interventions in improving symptom management among patients with advanced cancer.
• The effectiveness of nurse-led interventions in promoting hand hygiene compliance among healthcare workers.

Evidence-Based Practice Nursing Research Topic Ideas

• The effect of nurse-led education on medication adherence in patients with chronic illnesses.
• The use of telehealth to improve patient outcomes in rural communities.
• The impact of music therapy on pain management in postoperative patients.
• The effectiveness of mindfulness-based stress reduction in reducing burnout in nursing staff.
• The effect of exercise on the prevention of falls in elderly patients.
• The use of simulation-based training in improving clinical competency in nursing students.
• The effect of nurse-led discharge planning on readmission rates.
• The effectiveness of non-pharmacological interventions for agitation in patients with dementia.
• The impact of bedside reporting on patient safety and satisfaction.
• The effect of aromatherapy on anxiety in hospitalized patients.
• The use of standardized protocols to reduce catheter-associated urinary tract infections.
• The effectiveness of peer support in improving diabetes self-management.
• The impact of patient-centered care on outcomes for patients with chronic illnesses.
• The effect of nursing interventions on the prevention of pressure ulcers.
• The use of telemonitoring to improve outcomes in heart failure patients.
• The effect of early mobility programs on outcomes in critically ill patients.
• The effectiveness of team-based care in improving outcomes for patients with complex medical conditions.
• The use of acupressure to manage postoperative nausea and vomiting.
• The impact of nurse-led interventions on the prevention of central line-associated bloodstream infections.
• The effectiveness of cognitive-behavioral therapy in reducing symptoms of depression in patients with chronic illnesses.
• The effect of mindfulness-based interventions on pain management in cancer patients.
• The use of telepsychiatry in improving access to mental health care in rural communities.
• The effectiveness of nurse-led smoking cessation interventions.
• The impact of a family-centered care approach on outcomes for critically ill pediatric patients.
• The effect of nurse-led interventions on medication adherence in patients with hypertension.
• The use of music therapy to improve sleep in hospitalized patients.
• The effectiveness of patient education in reducing hospital readmissions.
• The impact of nursing interventions on the prevention of falls in hospitalized patients.
• The effect of nurse-led interventions on glycemic control in patients with diabetes.
• The use of mindfulness-based interventions to reduce stress in nursing students.
• The effectiveness of nurse-led interventions in reducing healthcare-associated infections.
• The impact of a multidisciplinary approach to pain management on outcomes for patients with chronic pain.
• The effect of nurse-led interventions on the prevention of ventilator-associated pneumonia.
• The use of telehealth to provide palliative care to patients with advanced illnesses.
• The effectiveness of nurse-led interventions in reducing the incidence of pressure injuries in long-term care facilities.
• The impact of a nurse-led transitional care program on outcomes for patients with heart failure.
• The effect of a nurse-led sepsis protocol on early recognition and treatment.
• The use of animal-assisted therapy in the management of anxiety and depression in hospitalized patients.
• The effectiveness of a nurse-led motivational interviewing intervention in improving self-care behaviors in patients with chronic illnesses.
• The impact of a nurse-led hand hygiene program on healthcare-associated infections.
• The effect of nurse-led interventions on the prevention of surgical site infections.
• The use of telehealth to provide mental health services to underserved populations.
• The effectiveness of nurse-led interventions in improving pain management in elderly patients with dementia.
• The impact of a nurse-led transitional care program on outcomes for patients with chronic obstructive pulmonary disease.
• The effect of a nurse-led program on the prevention of urinary tract infections in long-term care facilities.

Nursing Research Topic Ideas Medical Surgical Nursing

• The Effectiveness of Pre-operative Education on Patient Outcomes in Medical-Surgical Nursing.
• A Comparative Study of the Effect of Manual Turning vs. Mechanical Turning on Pressure Injury Prevention in Hospitalized Patients.
• The Impact of Postoperative Pain Management on the Length of Hospital Stay for Surgical Patients.
• The Role of Nursing Interventions in Reducing the Incidence of Falls in Medical-Surgical Units.
• The Effect of Nursing Shortage on Patient Outcomes in Medical-Surgical Units.
• A Study of Nurse-Patient Communication and its Impact on Patient Satisfaction in Medical-Surgical Units.
• The Efficacy of Non-pharmacological Interventions in Reducing Anxiety and Stress among Medical-Surgical Patients.
• A Comparison of Standardized Nursing Care Plans vs. Individualized Nursing Care Plans in Medical-Surgical Units.
• The Impact of Nurse Staffing Levels on Patient Outcomes in Medical-Surgical Units.
• A Study of Medication Adherence among Medical-Surgical Patients.
• The Effect of Family-Centered Care on Patient Outcomes in Medical-Surgical Units.
• A Study of Wound Care Management in Medical-Surgical Nursing.
• The Impact of Nursing Rounds on Patient Outcomes in Medical-Surgical Units.
• A Comparison of Two Nursing Care Models in Medical-Surgical Units.
• A Study of Pain Management Practices in Medical-Surgical Nursing.
• The Effectiveness of Discharge Planning on Patient Outcomes in Medical-Surgical Nursing.
• A Comparative Study of the Effect of Traditional vs. High-Fidelity Simulation Training on Nursing Competence in Medical-Surgical Units.
• The Impact of Multidisciplinary Rounds on Patient Outcomes in Medical-Surgical Units.
• A Study of Hand Hygiene Practices among Medical-Surgical Nurses.
• The Effect of Mindfulness-Based Interventions on Nurses’ Well-being and Job Satisfaction in Medical-Surgical Units.
• A Comparative Study of the Effect of Bedside Shift Reporting vs. Traditional Shift Reporting on Patient Safety in Medical-Surgical Units.
• The Impact of Nursing Education on Pressure Injury Prevention in Medical-Surgical Nursing.
• A Study of Nurse Leadership Styles and their Effect on Patient Outcomes in Medical-Surgical Units.
• The Effect of Teamwork on Patient Safety in Medical-Surgical Units.
• A Comparative Study of the Effect of Electronic Health Records vs. Paper-Based Records on Nursing Documentation in Medical-Surgical Units.
• The Impact of Nursing Knowledge on Medication Safety in Medical-Surgical Nursing.
• A Study of Palliative Care Practices in Medical-Surgical Nursing.
• The Effect of Exercise Interventions on the Rehabilitation of Medical-Surgical Patients.
• A Comparative Study of the Effect of RN-BSN Programs vs. ADN Programs on Nursing Competence in Medical-Surgical Units.
• The Impact of Cultural Competence on Patient Satisfaction in Medical-Surgical Units.
• A Study of Advanced Practice Nursing in Medical-Surgical Units.
• The Effectiveness of Clinical Decision Support Systems on Medication Safety in Medical-Surgical Nursing.
• A Comparative Study of the Effect of Direct vs. Indirect Care on Nursing Workload in Medical-Surgical Units.
• The Impact of Staff Education on Sepsis Management in Medical-Surgical Nursing.
• A Study of Patient Education Practices in Medical-Surgical Nursing.
• The Effect of Nursing Care Models on Patient Safety in Medical-Surgical Units.
• A Comparative Study of the Effect of Nurse-led vs. Physician-led Rounds on Patient Outcomes in Medical-Surgical Units.
• The Impact of Patient Experience on Nurse Job Satisfaction in Medical-Surgical Units.
• A Study of Medication Errors in Medical-Surgical Nursing.

Nursing Research Topics About Community

• The effectiveness of community health worker programs in improving health outcomes among underserved populations
• The role of nurses in promoting community-based health initiatives and prevention programs
• The impact of neighborhood characteristics on health outcomes and health behaviors
• The effectiveness of nurse-led interventions in reducing health disparities in rural communities
• Examining the effects of community-based palliative care programs on end-of-life care
• Investigating the factors influencing healthcare access and utilization among homeless populations
• The impact of nurse-led interventions on vaccination rates in low-income communities
• Assessing the effectiveness of nurse-led telehealth programs in rural and remote communities
• Examining the role of community-based nursing in disaster preparedness and response
• The effects of social determinants of health on maternal and child health outcomes in disadvantaged communities
• Investigating the impact of nurse-led interventions on substance abuse and addiction in community settings
• The effectiveness of community-based health promotion programs in reducing obesity rates
• The impact of cultural competency training on nursing practice in diverse communities
• Examining the effects of community-based nursing on healthcare costs and utilization
• Investigating the effectiveness of nurse-led interventions in improving mental health outcomes in community settings
• The role of nurses in promoting healthy aging and preventing age-related illnesses in community settings
• The effects of community-based interventions on reducing hospital readmissions for chronic conditions
• The impact of nurse-led interventions on access to healthcare for undocumented immigrants
• The effectiveness of school-based nurse-led interventions in promoting adolescent health
• Examining the effects of community-based nursing on reducing emergency department visits for non-emergent conditions
• Investigating the impact of nurse-led interventions on reducing infant mortality rates in disadvantaged communities
• The role of nurses in promoting health equity and reducing health disparities in underserved communities
• The effects of community-based nursing on improving medication adherence and reducing medication errors
• The impact of nurse-led interventions on improving health literacy in disadvantaged communities
• Investigating the effectiveness of community-based nursing in reducing readmissions for heart failure patients
• The role of nurses in promoting healthy aging and preventing age-related illnesses in long-term care settings
• Examining the effects of community-based nursing on reducing healthcare costs for chronic conditions
• Investigating the impact of nurse-led interventions on reducing sexually transmitted infections in high-risk communities
• The effectiveness of community-based nursing in reducing hospital-acquired infections in long-term care facilities
• The role of nurses in promoting mental health and well-being in community settings
• The effects of community-based nursing on reducing healthcare utilization for chronic conditions
• Investigating the impact of nurse-led interventions on reducing healthcare costs for low-income populations
• The effectiveness of nurse-led interventions in improving health outcomes among immigrant populations
• Examining the role of community-based nursing in promoting healthy lifestyle behaviors in high-risk populations
• Investigating the impact of nurse-led interventions on improving health outcomes for LGBTQ+ populations
• The effectiveness of nurse-led interventions in promoting breast cancer screening in disadvantaged communities
• The role of nurses in promoting health equity and reducing health disparities in migrant populations
• The effects of community-based nursing on improving end-of-life care for patients with advanced illness
• Investigating the impact of nurse-led interventions on improving health outcomes for individuals with disabilities in community settings
• The effectiveness of nurse-led interventions in reducing rates of cardiovascular disease in high-risk communities
• Examining the role of community-based nursing in promoting healthy eating behaviors and reducing food insecurity
• Investigating the impact of nurse-led interventions on reducing healthcare costs for chronic pain management in community settings

Nursing Research Topics for BSc Students

• The impact of nursing interventions on patient satisfaction in post-operative care.
• The relationship between nurse staffing levels and patient outcomes in ICU.
• The role of the nurse in promoting patient safety in a pediatric setting.
• The effectiveness of simulation-based training in nursing education.
• The impact of electronic medical records on nursing practice.
• The experiences of nursing students during clinical placements.
• The role of the nurse in managing chronic illness in the elderly.
• The relationship between nursing care and patient outcomes in palliative care.
• The effectiveness of interprofessional collaboration in healthcare teams.
• The impact of nursing leadership styles on job satisfaction and retention.
• The role of the nurse in promoting self-management in patients with chronic conditions.
• The effectiveness of mindfulness-based interventions for nursing students.
• The relationship between nurse staffing and patient mortality in acute care settings.
• The experiences of nurses working in rural healthcare settings.
• The role of the nurse in promoting health literacy among patients.
• The effectiveness of nursing interventions for reducing hospital readmissions.
• The relationship between nurse burnout and patient safety.
• The experiences of family caregivers of patients with dementia.
• The role of the nurse in managing symptoms in patients with cancer.
• The impact of cultural competence on patient-centered care.
• The relationship between nursing care and patient outcomes in psychiatric settings.
• The experiences of nurses working in home healthcare settings.
• The role of the nurse in promoting healthy lifestyle choices among patients.
• The effectiveness of nursing interventions for reducing healthcare-associated infections.
• The relationship between nurse staffing and patient satisfaction in emergency departments.
• The experiences of nurses working with patients with substance abuse disorders.
• The role of the nurse in promoting medication adherence in patients with chronic conditions.
• The impact of technology on nursing practice and patient outcomes.
• The relationship between nursing education and patient outcomes.
• The experiences of nurses working with patients with developmental disabilities.
• The role of the nurse in promoting patient-centered care in long-term care settings.
• The effectiveness of nurse-led care for patients with chronic conditions.
• The relationship between nurse staffing and patient outcomes in rehabilitation settings.
• The experiences of nurses working in hospice care.
• The role of the nurse in promoting mental health and wellness in patients.
• The impact of nursing interventions on patient outcomes in maternal and child health.
• The relationship between nurse burnout and patient outcomes in critical care settings.
• The experiences of nurses working with patients with eating disorders.
• The role of the nurse in promoting patient safety in surgical settings.
• The effectiveness of nursing interventions for reducing pain in patients with chronic conditions.
• The relationship between nursing care and patient outcomes in primary care settings.
• The experiences of nurses working in disaster response settings.
• The role of the nurse in promoting cultural humility in healthcare.
• The impact of nursing interventions on patient outcomes in infectious disease management.
• The relationship between nurse staffing and patient outcomes in neonatal care.
• The experiences of nurses working with patients with traumatic brain injuries.
• The role of the nurse in promoting end-of-life care and advance care planning.
• The effectiveness of nurse-led interventions for managing depression in patients with chronic conditions.
• The relationship between nursing care and patient outcomes in geriatric care.
• The experiences of nurses working in correctional healthcare settings.

About the author

Muhammad Hassan

Researcher, Academic Writer, Web developer

You may also like

500+ Sports Research Topics

300+ Mental Health Research Topics

500+ Google Scholar Research Topics

1100+ Research Paper Topics

500+ Economics Research Topics

500+ Criminal Justice Research Topics

• What is Peer-Reviewed Information?
• Literature Reviews
• How to Read a Scholarly Article
• Types of Research Articles

Identifying a Primary or Secondary Research Article

Differences between qualitative and quantitative research.

• What Kind of Article Is This?
• Evidence-Based Practice
• Primo - The Library's Discovery Tool This link opens in a new window
• Elements of Keyword Searching
• Using CINAHL Complete
• Concept Analysis
• Nursing Theory / Conceptual Framework
• Find Articles with a Nurse as an Author
• Nonparametric Tests
• Globalization Group Project - Professional Development I
• Simulations and Streaming Video
• Health Statistics
• Clinical Practice Guidelines
• Annotated Bibliographies
• RefWorks This link opens in a new window
• Other Helpful Guides

Here are some criteria for evaluating if a research article is primary or secondary:

• Consists of original studies conducted by the authors
• Includes: controlled trials, cohort studies, case studies
• Includes: methods, results, tables, figures
• Consists of assimilated evidence from a number of high-quality primary studies
• Includes: systematic review, meta-analyses, evidence summaries
• May include: methods as a literature review, cited tables, and results from other studies
• Example 1 - Primary or Secondary?
• Example 2 - Primary or Secondary?

" Quantitative research ," also called " empirical research ," refers to any research based on something that can be accurately and precisely measured.  For example, it is possible to discover exactly how many times per second a hummingbird's wings beat and measure the corresponding effects on its physiology (heart rate, temperature, etc.).

" Qualitative research " refers to any research based on something that is impossible to accurately and precisely measure.  For example, although you certainly can conduct a survey on job satisfaction and afterwards say that such-and-such percent of your respondents were very satisfied with their jobs, it is not possible to come up with an accurate, standard numerical scale to measure the level of job satisfaction precisely.

It is so easy to confuse the words "quantitative" and "qualitative," it's best to use "empirical" and "qualitative" instead.

Hint: An excellent clue that a scholarly journal article contains empirical research is the presence of some sort of statistical analysis .

Examples of Qualitative vs Quantitative

Courtesy of Ebling Library, University of Wisconsin - Madison Health Sciences  

More information on the definitions of the different kinds of studies in medical research is available in this easy-to-understand article on the subject:

Röhrig, B., Prel, J.-B. du, Wachtlin, D., & Blettner, M. (2009). Types of Study in Medical Research . Deutsches Ärzteblatt International. https://doi.org/10.3238/arztebl.2009.0262

• << Previous: How to Read a Scholarly Article
• Next: What Kind of Article Is This? >>
• Last Updated: Sep 3, 2024 1:58 PM
• URL: https://lewisu.libguides.com/nursing

The university of tulsa Online Blog

Trending topics in the tu online community

Nursing Research: What It Is and Why It Matters

When people think about medical research, they often think about cutting-edge surgical procedures and revolutionary new medications. As important as those advancements are, another type of research is just as vital: nursing research.

This type of research informs and improves nursing practice. In many cases, it’s focused on improving patient care. Experienced nurses who have advanced nursing degrees and training in research design typically conduct this research.

Nurse research can explore any number of topics, from symptomology to patient diet. However, no matter the focus of a research project, nurse research can improve health care in an impressive number of ways. As experts in their field, nurse researchers can pursue a wide range of unique career advancement opportunities .

Why Nursing Research Matters: Examples of Research in Action

Research drives innovation in every industry. Given that nurses are on the front line of the health care industry, the research they do can be particularly impactful for patient outcomes. 

It Can Improve Patients’ Quality of Life

Patients diagnosed with life-threatening chronic diseases often undergo intense treatments with sometimes debilitating side effects. Nursing research is vital to helping such patients maintain a high quality of life.

For example, a 2018 study led by a nurse scientist explored why cancer patients undergoing chemotherapy frequently experience severe nausea. While the physical toll of chemotherapy contributes to nausea, the study found that patients who have factors such as children to take care of, high psychological stress, and trouble performing day-to-day tasks are often much more likely to experience nausea.

By identifying the root causes of nausea and which patients are more likely to experience it, this research allows health care professionals to develop evidence-based care practices . This can include prescribing anti-nausea medications and connecting patients to mental health professionals.

It’s Central to Making Health Care More Equitabl

A Gallup survey reports that about 38% of Americans put off seeking medical treatment due to costs. Unfortunately, cost is only one factor that prevents people from seeking treatment. Many Americans don’t live close to medical providers that can meet their needs, aren’t educated about health, or encounter discrimination.

As complex as this issue is, the National Institute of Nursing Research (NINR) asserts that the country’s nurse researchers can lead the charge in tackling it. In its strategic plan for 2022 to 2026, the institute highlights the following:

• Nursing has long been one of the most trusted professions in the country.
• Nurses often interact with patients, patients’ families, and communities more frequently than other health care professionals.
• The care that nurses provide must often take environmental and social factors into account.

These traits put nurses in the position to not only research health inequity but also put their research to work in their organizations. To help make that happen, NINR often funds nurse-led research projects focused on equity and social determinants of health. With that kind of backing, the field may become more transformative than ever.

It Can Strengthen the Health Care Workforce

While nursing research can be used to improve patient care, it can also be leveraged to solve issues health care professionals face daily. Research about the state of the health care workforce during the COVID-19 pandemic is a perfect illustration.

In 2022, a team of nurse researchers published a report called Nursing Crisis: Challenges and Opportunities for Our Profession After COVID-19 in the International Journal of Nursing Practice . In it, the authors provided concrete statistics about the following:

• Mental and physical health issues many nurses encountered
• Effects of increased workloads and decreased nurse-to-patient ratios
• How many nurses were planning to leave the profession altogether

As nurses themselves, the authors also offer actionable, evidence-based solutions to these issues, such as streamlining patient documentation systems and implementing employee wellness programs.

However, this type of research isn’t just important to solving workforce issues stemming from specific emergencies, such as the COVID-19 pandemic. By publishing quantifiable data about the challenges they face, nurse researchers empower other nurses and professional nursing organizations to advocate for themselves. This can help employers enact effective policies, support their nursing staff, and draw more talented people into the profession.

Career Opportunities in Nursing Research

Nurse researchers can work in any number of administrative, direct care, and academic roles. However, because nurse research often requires clinical care and data analysis skills, jobs in this field typically require an advanced degree, such as a Master of Science in Nursing (MSN).

While many more nurse research career opportunities exist, here are four career paths nurses with research experience and advanced degrees can explore.

Nurse Researcher

Nurse researchers identify issues related to nursing practice, collect data about them, and conduct research projects designed to inform practice and policy. While they often work in academic medical centers and universities, they can work for any type of health care provider as well as health care advocacy agencies.

In addition to conducting research, these professionals typically provide direct patient care. Many also write papers for peer-reviewed journals and make presentations about their work at conferences.

Clinical Research Nurse

Despite having a similar title to nurse researchers, clinical research nurses have slightly different responsibilities. These professionals are usually in charge of providing care to patients participating in medical research projects, including clinical trials and nursing research initiatives. They also typically collect data about patient progress, coordinate care between different team members, and contribute to academic papers.

Occupational Health Nurse

Also referred to as environmental health nurses, occupational health nurses serve specific communities, such as professionals in a particular industry or people who live in a particular area. They often educate their communities about relevant health risks, advocate for stronger health and safety regulations, and run wellness programs.

To carry out their duties, occupational and environmental health nurses must typically research health trends about the people they serve, including living and working conditions that put them at risk for illness or injury. They can work for private companies and government agencies.

Nurse Educator

Nurse educators prepare new nurses to enter the workforce or train experienced nurses in more advanced techniques. This can include teaching classes and providing on-the-job training. They often work for colleges, universities, and large health care providers.

While their duties don’t always include research, nurse educators must keep up with the health care industry’s needs and new patient care practices. This is so they can provide relevant education themselves and help their organizations design up-to-date curricula.

Make Nursing Research a Part of Your Journey

Conducting and implementing nurse research is a collaborative effort. It takes a team of informed leaders, skilled analysts, and creative educators to create effective, evidence-based policies. Those interested in pursuing nurse research should consider The University of Tulsa’s online MSN program , which can prepare you to fill any one of those roles and more.

All of TU’s MSN students take classes on research and evidence-based practices. However, the program’s specialty tracks allow students to take their studies in multiple research-oriented directions. For instance, if you’re interested in collecting and interpreting clinical data, you can choose the Informatics and Analysis track. If you have a passion for public health policy, the Public Health and Global Vision track includes classes on population health and epidemiology.

Delivered in a flexible online format, this program can be a great option for working nurses and nontraditional students alike. To find out more, read about TU’s admission policies and request more information today.

Recommended Readings

A Nurse Educator’s Role in the Future of Nursing

How Global Health Nursing Supports Population Health

What Can You Do With an MSN?

Gallup, “Record High in U.S. Put Off Medical Care Due to Cost in 2022”

International Journal of Nursing Practice, “Nursing Crisis: Challenges and Opportunities for Our Profession After COVID‐19”

Journal of Pain Symptom Management , “Risk Factors Associated With Chemotherapy-Induced Nausea in the Week Prior to the Next Cycle and Impact of Nausea on Quality of Life Outcomes”

Mayo Clinic, Nursing

National Institute of Nursing Research, Scientific Strategy: NINR’s Research Framework

National Institute of Nursing Research, The National Institute of Nursing Research 2022-2026 Strategic Plan

Recent Articles

How Leaders Drive Quality Improvement in Nursing

University of Tulsa

Aug 23, 2024

Wellness Nurse: Career Definition and More

Types of Nursing Degrees

Aug 21, 2024

Learn more about the benefits of receiving your degree from The University of Tulsa

• Online Program Tuition
• AGACNP Certificate Online
• Online MSN Program
• Accelerated Online BSN
• RN to BSN Program
• RN to MSN Program
• MS in Cyber Security
• Meet the Team
• Nursing Student Practicum Requirements
• Disclosures for Professional Nursing Licensure
• On Campus Programs

• Open access
• Published: 05 September 2024

Impact of narrative nursing cognition, self-efficacy, and social support on the practices of registered nurses in China: a structural equation modeling analysis

• Li Zhang 1 ,
• Qiang Han 1 ,
• Lin Nan 2 &
• Huiyun Yang 3  

BMC Nursing volume  23 , Article number:  624 ( 2024 ) Cite this article

Metrics details

Narrative nursing is a novel approach according with humanistic care, which has been shown to be effective in improving health outcomes for both patients and nurses. Nevertheless, few studies have investigated the status of narrative nursing practice among nurses, and a comprehensive understanding of factors influencing this practice remains elusive.

This was an observational, cross-sectional study using convenience sampling method.

After obtaining the informed consent, a total of 931 registered nurses from three hospitals in China were investigated. Data were collected using the Social Support Rating Scale, the General Self-efficacy Scale, and the Knowledge-Attitude-Practice Survey of Clinical Nurses on Narrative Nursing. All the scales were validated in the Chinese population. The questionnaire results were verified by an independent investigator. Factors influencing narrative nursing practice were determined through a series of analyses, including independent sample t-tests, one-way ANOVA, and Pearson correlations. Subsequently, path analysis was performed and a structural equation model was established.

The score of narrative nursing practice in this study was 30.26 ± 5.32. The structural equation model showed a good fit, with a Root Mean Square Error of Approximation (RMSEA) of 0.007 (90%CI: 0.000, 0.047). Both social support and narrative nursing attitude could directly affect narrative nursing practice (βsocial support = 0.08, P  < 0.001; βattitude = 0.54, P  < 0.001) and indirectly influence it via self-efficacy ( β social support  = 0.04, P  < 0.001; β attitude  = 0.06, P  < 0.001). In addition, narrative nursing knowledge ( β  = 0.08, P  < 0.001) and the nurses’ growth environment ( β =-0.06, P  < 0.001) also affected the practice of narrative nursing.

Narrative nursing in China is at a medium level and could be influenced by several personal and environmental factors. This study highlighted the critical role of nursing management in the advancement of narrative nursing practices. Nurse managers should prioritize specialized training and cultivate supportive environments for nurses to improve their narrative nursing practices.

Peer Review reports

Nurses are the largest group of healthcare professionals, and their initial assessment and subsequent care are critical for favorable health outcomes [ 1 ]. Humanistic care is the cornerstone of nursing practice [ 2 ], which is also a vital approach to promoting global health, according to the statements by the International Council of Nurses [ 3 ]. However, with the rise of science-centered medicine, the emphasis on humanistic care has diminished [ 4 ]. Research has revealed that 76.9% of medical disputes arise from a lack of humanistic care [ 5 ], which can adversely affect both patients and nurses/nurse practitioners. For instance, patients who do not receive sufficient humanistic care may feel insecure, express dissatisfaction with hospitalization, and encounter strained doctor-patient relationships [ 6 ]. Nurses, on the other hand, may suffer from anxiety and depression [ 7 ] and experience job burnout [ 8 ]. Therefore, practicing humanistic care has extremely important significance.

Narrative nursing is a key practice in humanistic care, which aims to provide patient- and family-centered care by interpreting narrative tales and integrating knowledge, beliefs, and values within the nurse-patient interaction context [ 9 ]. Narrative nursing can be augmented by focusing on the analysis of unfolding case studies, utilizing interactive teaching methods, and incorporating the practical realities of nursing care [ 10 ]. Storytelling is the core technique of narrative nursing, which requires nurses to continuously inquire about the issues encountered by patients and families and assess their needs and preferences for patient- and family-centered care [ 9 ]. Narrative nursing is considered successful when patients and their families feel cared for. Narrative nursing helps patients cope with disease and restores their meaning in life through focused listening and reactive nursing practices [ 11 ]. Patients receiving narrative nursing reported calmness of mind [ 12 ], relief from depression and anxiety [ 13 ], and improvement in their quality of life [ 14 ]. Additionally, narrative nursing has the potential to reduce nurses’ work-related stress [ 15 ] and mitigate the ethical challenges faced in clinical practice [ 16 ].

Although narrative nursing has obvious advantages, the implementation process still faces a series of challenges, such as the lack of standardized clinical nurse-patient communication models and significant differences in mutual understanding levels between nurses and patients [ 17 ]. To address these issues, it is imperative to identify the potential factors influencing the effectiveness of narrative nursing and develop targeted strategies accordingly.

According to Bandura’s theory, personal cognition, which encompasses knowledge and attitudes, directly affects behavioral activities by predicting and modulating behavior [ 18 ]. Previous research corroborates this finding, demonstrating that healthcare professionals’ cognitive attitudes toward trauma-informed care practices positively impact their implementation of such practices [ 19 ]. In this study, nurses’ personal cognition of their knowledge and attitudes toward narrative nursing were also expected to influence their narrative nursing practices. In addition, a positive attitude towards narrative nursing can boost nurses’ confidence in their capabilities, indirectly enhancing narrative nursing practices through increased self-efficacy [ 20 ]. Therefore, self-efficacy may serve as a mediating factor in the relationship between nurses’ attitudes toward narrative nursing and their narrative nursing practices.

Social support also influenced narrative nursing practices. Social support, defined as emotional and tangible assistance provided by family, friends, colleagues, and other significant individuals [ 21 ], is understood through main and buffering effect models [ 22 ]. The main effects model suggests that social support invariably benefits individuals, regardless of their stress or distress levels. Research has shown that individuals who receive social support are less likely to experience compassion fatigue and can manage stress more effectively to promote narrative nursing [ 23 ]. Furthermore, high social support can help nursing personnel proactively prevent adverse performances and maintain a more positive emotional experience, effectively mitigating the physical and psychological impacts of occupational stress [ 24 ]. By enhancing nurses’ self-efficacy through positive experiences, social support can indirectly improve the quality and efficiency of narrative nursing [ 25 ]. Thus, theoretically, social support may indirectly influence narrative nursing practices through self-efficacy. Thus, we hypothesized that the practice of narrative nursing is contingent upon the synergistic effects of personal factors, such as knowledge and attitude regarding narrative nursing, and environmental factors, such as social support, which indirectly affect narrative nursing practice through self-efficacy. A theoretical model illustrating these relationships is presented in Fig.  1 .

Due to that the existing knowledge gap regarding the current state and factors influencing narrative nursing practices, we conducted this cross-sectional study to primarily understand these aspects, offering empirical evidence for subsequent longitudinal and intervention-based studies. This study aimed to identify and understand how personal factors, such as knowledge and attitude, and environmental elements, such as social support, influence the practice of narrative nursing.

Three hypotheses were proposed: (1) personal factors, including both knowledge and attitude, directly impact the practice of narrative nursing, (2) environmental factors, such as social support, also directly affect the practice of narrative nursing, and (3) self-efficacy serves as a mediator between personal and environmental factors that influence the practice of narrative nursing.

Hypothetical model of the relationships among personal factors, environmental factors, and narrative nursing practice

Study design and participants

This study was designed as a multi-center cross-sectional investigation using convenience sampling to obtain sufficient samples for developing our model. From March to October 2023, we surveyed 1091 nurses at three hospitals in Shanxi Province, China, and collected 931 questionnaires with a response rate of 85.34%. Nurses meeting the following criteria were invited to participate: (1) possession of a valid nursing practice license, (2) a minimum of one year of nursing experience providing care to sober patients, and (3) voluntary commitment to participate in this study. Individuals who (1) were not scheduled for duty during the survey period, (2) did not directly engage in nursing services (e.g., nurse managers), and (3) were advanced students and interns were excluded. All the participants provided written informed consent.

Setting and procedure

Having secured the consent of the nurse managers and nursing supervisors at each selected hospital, an electronic questionnaire was developed to facilitate an online survey using Sojump. Sojump is the most commonly used online survey platform in China and offers features such as data encryption, server stability, automated backups, and user-friendly interface. To prevent duplicate responses, the questionnaire was designed to allow for only one response per unique cell phone number or IP address. All the questions were configured as mandatory to ensure that the survey could not be submitted with any missing responses. Prior to the official survey launch, comprehensive training materials were provided to nursing leaders at the three hospitals, outlining the study’s objectives and importance, and detailing the precautions and response methods to be employed when completing the questionnaire. Subsequently, the survey data were verified by independent data processors to ensure completeness and reliability of the questionnaire.

Ethical considerations

This study adhered to the principle of the Declaration of Helsinki. Ethical approval was granted by the Medical Ethics Committee of The Second Affiliated Hospital of Xi’an Jiaotong University (Approval No. 2023004). Before the commencement of the investigation, participants were given an informed consent form. They were thoroughly informed of the voluntary and confidential nature of their involvement in this study. Emphasis was placed on the fact that their participation was entirely optional and that they had the unconditional right to withdraw from the study at any point without consequences or explanation. Additionally, they were assured that all collected data would remain anonymous and that their privacy would be strictly protected throughout the research process.

Sample size

According to Comrey and Lee [ 26 ], a sample size of approximately 300 is considered adequate for factor analysis. To further assess the statistical power, we conducted a post hoc analysis using G*Power 3.1 software to determine whether the sample size was sufficient. The analysis revealed that with 931 participants, a power of 100% was achieved at a significance level of 0.05 (two-side).

Social-demographic characteristics

A self-designed questionnaire was initially developed based on a literature review and considerations of clinical significance and was subsequently pilot tested by an independent statistician. A questionnaire was used to collect sociodemographic characteristics, including gender, age, marital status, working department, working years, educational level, growth environment, monthly income (RMB), and job satisfaction. Specifically, the growth environment was categorized as urban or rural, which referred to the places where the participants were born and raised.

Knowledge-attitude-practice survey of clinical nurses on narrative nursing

The Knowledge-Attitude-Practice Survey of Clinical Nurses on Narrative Nursing was used to evaluate the narrative nursing practice, knowledge and attitude of participants in this study [ 27 ]. The questionnaire consists of three subscales: practice (8 items), knowledge (6 items), and the attitude (8 items). Each item was rated on a scale of 1 to 5 points, based on a 5-level Likert scale scoring method. The total scores for Practice, Knowledge, and Attitude were to 8–40 points, 6–30 points, and 8–40 points, respectively. A higher score indicated a higher the level of practice, knowledge, or attitude towards narrative nursing. This scale has revealed good reliability and validity in previous study (Cronbach’s α = 0.844) [ 28 ], and in this study, the Cronbach’s α for practice, knowledge, attitude subscales were 0.835, 0.735, 0.891, respectively.

Perceived social support rating scale

The Perceived Social Support Rating Scale was employed to evaluate the social support received by nurses [ 29 ]. This scale comprises three dimensions: subjective, objective, and support utilization. It comprises 10 items, each item is scored on a scale from 1 to 7, with higher scores indicating a greater level of social support. This scale has demonstrated strong validity and reliability in the Chinese population (Cronbach’s α = 0.949) [ 30 ]. The Cronbach’s α of the scale in this study was 0.806.

General self-efficacy scale

The Chinese version of the General Self-efficacy Scale was used to evaluate nurses’ confidence in their capacity to participate in narrative approaches [ 31 ]. This scale consists of a single dimension with10 items. Each item is rated on a scale of 1–4, allowing for a total possible score range of 10–40 points. This scale has been validated in a Chinese population, with a previous study reporting a Cronbach’s α of 0.903 [ 32 ]. The Cronbach’s α of the scale in this study was 0.941.

Data analysis

Statistical analysis was conducted using IBM SPSS version 26.0 and AMOS version 20. The normality of the variables was evaluated by assessing the skewness and kurtosis. The variables were considered to be normally distributed if the skewness value was less than or equal to 2 or the kurtosis value was less than or equal to 4 [ 33 ]. All continuous data in our study adhered to a normal distribution. Thus, parametric tests were conducted. Specifically, independent sample t-tests (dichotomous variables), one-way ANOVA (polytomous variables), and Pearson’s correlations (continuous variables) were performed. Variables that exhibited significant differences during the univariate analysis ( P  < 0.2) [ 34 ] and potential factors identified through clinical experience were incorporated into the structural equation model. The structural equation model was conducted using bootstrap resampling techniques to detect direct and indirect relationships among the factors were analyzed, presenting standardized regression coefficients ( β ) and their corresponding p-values for direct, indirect, and total effects. Variables with non-significant coefficients were excluded from the model. Model fit was assessed using appropriate model fit indices [ 35 ]: a relative chi-square (χ2/df) test of less than 3 (indicates a good fit if P  > 0.05); adjusted goodness-of-fit index (AGFI) (adjusted measure of how well the model fits the data); comparative fit index (CFI) (compares the fit of the proposed model to a null model); normative fit index (NFI) (compares the fit of the model to a model where all variables are uncorrelated); incremental fit index (IFI) (similar to CFI, accounts for the degrees of freedom); and Tucker-Lewis Index (TLI) (like CFI, assesses model fit); all above 0.90, goodness-of-fit index (GFI) (overall measure of how well the model fits the data) above 0.80, and Root Mean Square Error of Approximation (RMSEA) (estimates the error of approximation in the model) less than 0.08. A p-values of less than 0.05 (two-tailed) were considered statistically significant.

A total of 931 participants were included in this study, with a slightly higher proportion of middle-aged individuals. Most participants held a bachelor’s degree or higher (81.95%), and their monthly income was mainly less than 5,000 RMB (46.19%). The other details are presented in Table  1 .

Univariate analysis

The independent sample t-test showed that there were significant differences in growth environment (MD = 0.94, 95%CI: 0.26 ~ 1.62, t  = 2.71, P  = 0.007) and having experience of hospitalized or accompanied (MD = 1.39, 95%CI: 0.55 ~ 2.23, t  = 3.23, P  = 0.001). For the one-way ANOVA, age ( F  = 4.08, P  = 0.017), working years ( F  = 4.97, P  = 0.007), workload ( F  = 6.46, P  = 0.002), job satisfaction ( F  = 26.14, P  < 0.001), and narrative nursing contact were significant factors ( F  = 25.17, P  < 0.001) (Table  1 ). These factors were used to validate of the structural equation model.

Correlations between variables

Correlations between the measurement variables were analyzed using Pearson’s correlation coefficient analysis (Table  2 ). We observed positive correlations among all the individual variables. In this study, the correlation coefficient between the latent variables ranged from 0.20 to 0.68, and the squared value was smaller than every AVE value; thus, discriminant validity was secured. Narrative nursing knowledge ( r  = 0.41, P  < 0.001), narrative nursing attitude ( r  = 0.68, P  < 0.001), social support ( r  = 0.35, P  < 0.001), and self-efficacy ( r  = 0.43, P  < 0.001) were statistically significant.

Structural equation model

Table  3 details the model’s results, revealing that nurses’ attitudes toward narrative nursing indirectly influenced narrative nursing practice through self-efficacy, with a desirable fitting index (Table  4 ). This relationship involved a direct effect of 0.54 ( P  < 0.001), an indirect effect of 0.06, and a total effect of 0.60 ( P  < 0.001). Knowledge of narrative nursing directly influenced narrative nursing practice with an effect of 0.08 ( P  < 0.001). Social support has an indirect impact on narrative nursing practice through self-efficacy, with a direct effect of 0.08 ( P  < 0.001), an indirect effect of 0.04, and a total effect of 0.12 ( P  < 0.001). In addition, the growth environment was also associated with narrative nursing practice ( β =-0.06, P  < 0.01). The refined model is presented in Fig.  2 .

Hypothesized Model of narrative nursing knowledge, narrative nursing attitude, social support, self-efficacy, growth environment, and narrative nursing practice

Summary of main results

The average score for nurses’ narrative nursing practice in this study was 30.26 ± 5.32, slightly higher than the previous study that investigated a total of 1993 nurses in China (28.27 ± 5.48) [ 36 ]. The structural equation model showed that narrative nursing attitudes and social support directly affected narrative nursing practice and indirectly influenced it via self-efficacy. In addition, narrative nursing knowledge and the growth environment were found to have an impact on narrative nursing practice. This study clarified the relationships between personal and environmental factors and narrative nursing practice, thus providing further insight into factors that may improve narrative nursing practice.

Model results

Attitude is central to the daily implementation of humanistic care, while knowledge provides basic theoretical guidance for nurses to engage in humanistic care practices [ 37 ]. In previous empirical research, both attitude and knowledge were found to significantly affect nursing practices, including the prevention of catheter-associated tract infections [ 38 ] and medical device-related pressure injuries [ 39 ]. This study confirmed that both narrative nursing knowledge and attitude could directly affect the practice of narrative nursing, thus verifying Hypothesis 1.

It has been proved that self-efficacy is intricately linked to the humanistic practices of narrative nursing [ 40 ]. This study further found that self-efficacy acted as a mediating factor in narrative nursing attitudes and practice, verifying our hypothesis 3. One possible mechanism is that self-efficacy is a dynamic process that can be modified by attitude, knowledge, feedback, and experience [ 41 ]. Once nurses gained higher levels of self-efficacy, they can effectively use their skills to accomplish challenging tasks [ 42 ]. Therefore, it is highly advisable to intensify and prioritize training and educational programs focused on narrative nursing, as this will significantly bolster nurses’ self-efficacy in engaging in narrative nursing practices.

Consistent with previous research findings [ 43 ], this study confirmed that social support can directly affect narrative nursing practice. Additionally, it could indirectly influence narrative nursing practice through self-efficacy, thus verifying hypotheses 2 and 3. Previous studies have highlighted that a strong social support network can provide emotional bolstering, guidance, and tangible assistance, which can exert a positive influence on an individual’s beliefs, performance, and overall functioning [ 43 ]. Hospital nurses who receive greater social support may experience higher personal achievement and lower levels of emotional exhaustion and burnout [ 44 ], which could increase job satisfaction and promote humanistic care [ 45 ]. In particular, social support within the workplace, such as advocacy for narrative nursing and the development of narrative nursing skills, can effectively increase the humanistic qualities of nursing staff and promote the practice of narrative nursing [ 46 ]. In addition, healthy workplace characteristics, such as harmonious nurse–physician relationships, may influence work performance [ 47 ]. These findings underscore the importance of reinforcing social support and nurturing nursing staff’s enthusiasm for narrative nursing, which can significantly enhance the quality of narrative nursing practice.

Notably, this study identified an association between nurses’ growth environment and their practice of narrative nursing, with nurses in urban areas exhibiting better narrative nursing practices, which has not been clearly stated in previous studies. A large-scale longitudinal study of American adults spanning various stages of adulthood, has found that urban-rural differences in the expression of these five personality traits [ 48 ]. City dwellers tend to score higher on cheerfulness and mental health [ 48 ], which are significant factors that affect the execution of humanistic care [ 45 ]. This could explain the findings of the present study. Accordingly, it is imperative that nursing managers focus on cultivating positive personality traits in nurses and promoting their psychological well-being. Training programs should be tailored to cater to a diverse range of nurse personalities while also enhancing their professional knowledge and fostering a deeper passion for nursing. Thus, the provision of humanistic care may be improved, encouraging narrative nursing practice.

Limitations

This study has several limitations. First, although we analyzed the research data based on a theoretical model, the cross-sectional design limited the inference of causality. Additional longitudinal and intervention studies are necessary to validate these findings. Second, despite being a multicenter study, we only included hospitals from one province. Therefore, questions might be raised about how the results can be generalized to other regions or countries. Future research should aim to replicate our study in different regions or countries to assess the consistency of our findings and determine the extent to which they can be generalized. Third, the variables in this study were measured using self-report questionnaires, and the results may have been overestimated, underestimated, or deviated.

Conclusions

This study identified crucial factors from both the personal and environmental perspectives that could directly or indirectly influence narrative nursing practice. The path relationships in our model highlight the necessity of a comprehensive strategy to promote the practice of narrative nursing. This includes specialized training that enhances their knowledge and skills in narrative care, as well as the creation of a supportive environment that encourages and facilitates the implementation of humanistic care. The findings offer a compelling rationale for policymakers and nurse managers to integrate narrative nursing into healthcare settings. In doing so, they can contribute to the provision of patient-centered care that is compassionate, effective, and aligned with the principles of narrative nursing.

Implications for future research

The global healthcare sector has long faced challenges stemming from the scarcity and unequal distribution of nursing personnel [ 49 ]. In 2022, the registered nurses in China only covered 3.7 per 1,000 individuals [ 50 ]. This scarcity has seriously affected the quality of both clinical care and humanistic care [ 51 ]. The findings suggest that a multifaceted approach should be developed to promote the practice of narrative nursing in China. First, it is recommended that nursing programs tailored to narrative nursing, including art-based narrative training [ 52 ] and reflective practice [ 10 ] to improve nurses’ knowledge of narrative nursing and foster an awareness and a desire to engage in such practices. These practices should be integrated into undergraduate and postgraduate nursing curricula to ensure a solid foundation for narrative nursing. In addition, simulation training for narrative nursing listening [ 53 ] and the use of narrative nursing case studies [ 54 ] can enhance nurses’ self-efficacy in implementing narrative nursing. By providing hands-on experience and practical examples, these methods enable nurses to apply narrative techniques in controlled environments, thereby enhancing their confidence in their abilities [ 10 ]. Moreover, within medical settings, fostering a supportive environment is crucial for promoting the practice of narrative nursing [ 55 ]. Therefore, nursing managers should provide more support for nurses. These include providing resources, addressing concerns, and creating a supportive environment that values and encourages narrative nursing. Subsequently, a narrative-based nursing model should be developed to emphasize the concept of patient-centered care [ 56 ], while also incorporating the considerations of cost-effectiveness.

Data availability

The datasets generated and/or analyzed during the current study are available from the corresponding author on reasonable request.

World Health Organization. (2024). Nursing and Midwifery. https://www.who.int/news-room/fact-sheets/detail/nursing-and-midwifery . Assessed 10 August 2024.

Watson J. The theory of human caring: retrospective and prospective. Nurs Sci Q. 1997;10(1):49–52. https://doi.org/10.1177/089431849701000114 .

Article   CAS   PubMed   Google Scholar  

International Council of Nurses. (2024). Nurses: A voice to lead. https://www.icn.ch/sites/default/files/inlinefiles/ICN_IND_Toolkit_English_FINAL_low%20res_0.pdf . Assessed 11 August 2024.

McCaffrey G. A humanism for nursing? Nurs Inq. 2019;26(2):e12281. https://doi.org/10.1111/nin.12281 .

Article   PubMed   Google Scholar  

Chen G. The effective reduction of violence against doctors through the improvement of medical humanistic care. J Multidisciplinary Healthc. 2023;16:1403–7. https://doi.org/10.2147/JMDH.S411674 .

Article   Google Scholar  

Panagioti M, Geraghty K, Johnson J, Zhou A, Panagopoulou E, Chew-Graham C, Peters D, Hodkinson A, Riley R, Esmail A. Association between physician burnout and patient safety, professionalism, and patient satisfaction: a systematic review and Meta-analysis. Jama Intern Med. 2018;178(10):1317–31.

Article   PubMed   PubMed Central   Google Scholar  

Maharaj S, Lees T, Lal S. Prevalence and risk factors of depression, anxiety, and stress in a cohort of Australian nurses. Int J Environ Res Public Health. 2018;16(1):61. https://doi.org/10.3390/ijerph16010061 .

Shen A, Wang Y, Qiang W. A multicenter investigation of caring behaviors and burnout among oncology nurses in China. Cancer Nurs. 2020;43(5):E246–53. https://doi.org/10.1097/NCC.0000000000000680 .

Horton-Deutsch S, Sherwood G. Reflective practice: transforming education and improving outcomes. Indianapolis, IN: Sigma Theta Tau International; 2017.

Google Scholar  

Fitzpatrick JJ. Narrative nursing: applications in practice, Education, and Research. Appl Nurs Res. 2017;37:67. https://doi.org/10.1016/j.apnr.2017.08.005 .

Zaharias G. What is narrative-based medicine? Narrative-based medicine. Can Fam Physician. 2018;64(3):176–80.

PubMed   PubMed Central   Google Scholar  

Wise M, Marchand LR, Roberts LJ, Chih MY. Suffering in advanced cancer: a randomized control trial of a narrative intervention. J Palliat Med. 2018;21(2):200–7. https://doi.org/10.1089/jpm.2017.0007 .

Xu H, Xu G, Liu Y, Mu X, Liu Y, Hu H. Effect of narrative nursing intervention based on targeted nursing intervention on anxiety and nursing satisfaction of patients with malignant tumors undergoing chemotherapy. J Healthc Eng. 2021;2021(4438446). https://doi.org/10.1155/2021/4438446 .

Siverová J, Bužgová R. The effect of reminiscence therapy on quality of life, attitudes to ageing, and depressive symptoms in institutionalized elderly adults with cognitive impairment: a quasi-experimental study. Int J Ment Health Nurs. 2018;27(5):1430–9. https://doi.org/10.1111/inm.12442 .

Williams-Reade J, Freitas C, Lawson L. Narrative-informed medical family therapy: using narrative therapy practices in brief medical encounters. Families Syst Health. 2014;32(4):416–25. https://doi.org/10.1037/fsh0000082 .

Saeedi S, Jouybari L, Sanagoo A, Vakili MA. The effectiveness of narrative writing on the moral distress of intensive care nurses. Nurs Ethics. 2019;26(7–8):2195–203. https://doi.org/10.1177/0969733018806342 .

Höglander J, Holmström IK, Lövenmark A, Van Dulmen S, Eide H, Sundler AJ. Registered nurse-patient communication research: an integrative review for future directions in nursing research. J Adv Nurs. 2023;79(2):539–62. https://doi.org/10.1111/jan.15548 .

Bandura A. Self-efficacy: toward a unifying theory of behavioral change. Psychol Rev. 2001;84(2):191–215. https://doi.org/10.1037/0033-295x.84.2.191 .

Bruce MM, Kassam-Adams N, Rogers M, Anderson KM, Sluys KP, Richmond TS. Trauma providers’ knowledge, views, and practice of trauma-informed care. J Trauma Nurs. 2018;25(2):131–8. https://doi.org/10.1097/JTN.0000000000000356 .

Antonini M, Bellier-Teichmann T, O’reilly L, Cara C, Brousseau S, Weidmann J, Roulet-Schwab D, Ledoux I, Konishi M, Pasquier J, Delmas P. Effects of an educational intervention to strengthen humanistic practice on haemodialysis nurses’ caring attitudes and behaviours and quality of working life: a cluster randomised controlled trial. Bmc Nurs. 2021;20(1):255. https://doi.org/10.1186/s12912-021-00729-6 .

Zimet GD, Powell SS, Farley GK, Werkman S, Berkoff KA. Psychometric characteristics of the multidimensional scale of perceived social support. J Pers Assess. 1990;55(3–4):610–7. https://doi.org/10.1080/00223891.1990.9674095 .

Cohen S, Wills TA. Stress, social support, and the buffering hypothesis. Psychol Bull. 1985;98(2):310–57.

Liu Y, Aungsuroch Y, Gunawan J, Zeng D. Job stress, psychological capital, perceived social support, and occupational burnout among hospital nurses. J Nurs Scholarsh. 2021;53(4):511–8. https://doi.org/10.1111/jnu.12642 .

Fallah N, Abdolahzadeh F, Lotfi B. Examining the interconnections among entrepreneurial passion, need for achievement, social support, entrepreneurial self-efficacy, and entrepreneurial intention among foreign language learners: a moderated mediation model. Entrepreneurship Educ. 2023;6(3):319–38.

Liu Y, Aungsuroch Y. Work stress, perceived social support, self-efficacy and burnout among Chinese registered nurses. J Nurs Adm Manag. 2019;27(7):1445–53. https://doi.org/10.1111/jonm.12828 .

Comrey AL, Lee HB. A first course in factor analysis. Lawrence Erlbaum Associates; 1992.

Zhang L, Nan L, Han Q, Xue J, Dou Y, Li J. Analysis of the status quo and influencing factors of narrative nursing knowledge, attitude and behavior among nurses in tertiary hospitals. Chin Med Ethics. 2023;36(8):897–903. https://doi.org/10.12026/j.issn.1001-8565.2023.08.12 . (in Chinese).

Liao F, Hou M, Lin B, Li P. Analysis of the status quo and influencing factors of narrative nursing knowledge, attitude and practice of oncology nurses. Mod Clin Nurs. 2021;20(08):17–22.

Nolten PW. Conceptualization and measurement of social support: the development of the student social support scale. The University of Wisconsin-Madison; 1994.

Liu JW, Li FY, Lian YL. Reliability and validity of social support rating scale. J Xinjiang Med Univ. 2008;1:4–6. (in Chinese).

Zhang JX, Schwarzer R. Measuring optimistic self-beliefs: a Chinese adaptation of the general self-efficacy scale. Psychologia. 1995;38:174–81.

Cheng L, Ye Y, Zhong Z, Zhang F, Hu X, Cui R, Chen Q. Mediating effects of general self-efficacy on the relationship between the source of meaning in life and prosocial behaviours in vocational college nursing students: a cross-sectional study. PLoS ONE. 2020;15(12):e0243796. https://doi.org/10.1371/journal.pone.0243796 .

Article   CAS   PubMed   PubMed Central   Google Scholar  

Kim JS, Kim J, Gelegjamts D. Knowledge, attitude and self-efficacy towards palliative care among nurses in Mongolia: a cross-sectional descriptive study. PLoS ONE. 2020;15(7):e0236390. https://doi.org/10.1371/journal.pone.0236390 .

Maldonado G, Greenland S. Simulation study of confounder-selection strategies. Am J Epidemiol. 1993;138(11):923–36.

Hooper D, Coughlan J, Mullen M. (2008). Structural equation modelling: Guidelines for determining model fit structural equation modelling: Guidelines for determining model fit. Electron J Bus Res Methods. 2008; 6 : 53–60. View Article.

Li XZ, Zhou BZ, Wang NY. Investigation on nurses’ cognition condition and influence factors about the narrative nursing in the tertiary hospitals. J Mod Med Health. 2024;40(4):634–8. (in Chinese).

Delmas P, O’Reilly L, Iglesias K, Cara C, Burnier M. Feasibility, acceptability, and preliminary effects of educational intervention to strengthen humanistic practice among hemodialysis nurses in the Canton of Vaud, Switzerland: a pilot study. Int J Hum Caring. 2016;20(1):31–43.

Mong I, Ramoo V, Ponnampalavanar S, Chong MC, Wan Nawawi WNF. Knowledge, attitude and practice in relation to catheter-associated urinary tract infection (CAUTI) prevention: a cross-sectional study. J Clin Nurs. 2022;31(1–2):209–19. https://doi.org/10.1111/jocn.15899 .

Zhang YB, He L, Gou L, Pei JH, Nan RL, Chen HX, Wang XL, Du YH, Yan H, Dou XM. Knowledge, attitude, and practice of nurses in intensive care unit on preventing medical device-related pressure injury: a cross-sectional study in western China. Int Wound J. 2021;18(6):777–86. https://doi.org/10.1111/iwj.13581 .

Bu M, Ma H, Zhai H, Ma Y, Xu N. Role of self-efficacy in nursing organizational climate: a way to develop nurses’ humanistic practice ability. J Nurs Adm Manag. 2022;30(7):2107–15. https://doi.org/10.1111/jonm.13516 .

Croy G, Garvey L, Willetts G, Wheelahan J, Hood K. Anxiety, flipped approach and self-efficacy: exploring nursing student outcomes. Nurse Educ Today. 2020;93:104534. https://doi.org/10.1016/j.nedt.2020.104534 .

Kim SM, Kim JH, Kwak JM. Psychometric properties of the Korean version of the nursing profession self-efficacy scale. J Nurs Res. 2022;30(2):e197. https://doi.org/10.1097/jnr.0000000000000481 .

Patterer AS, Yanagida T, Kühnel J, Korunka C. Daily receiving and providing of social support at work: identifying support exchange patterns in hierarchical data. Eur J Work Organizational Psychol. 2023;32(4):489–505.

Al-Hamdan Z, Bani Issa H. The role of organizational support and self-efficacy on work engagement among registered nurses in Jordan: a descriptive study. J Nurs Adm Manag. 2022;30(7):2154–64. https://doi.org/10.1111/jonm.13456 .

Liu X, Zhu H. Influencing factors of humanistic care ability and its dimensions among mental health workers during the COVID-19 pandemic: an online cross-sectional study. BMC Psychiatry. 2023;23(1):186. https://doi.org/10.1186/s12888-023-04656-5 .

Zhang T, Zhang L, Wen X, Li H. Level of humanistic care ability and its influencing factors among nursing aides in long-term care facilities. Geriatr Nurs. 2023;52:56–62. https://doi.org/10.1016/j.gerinurse.2023.05.007 .

Kittel AFD, Kunz RAC, Seufert T. Self-regulation in informal workplace learning: influence of organizational learning culture and job characteristics. Front Psychol. 2021;12:643748. https://doi.org/10.3389/fpsyg.2021.643748 .

Atherton OE, Willroth EC, Graham EK, Luo J, Mroczek DK, Lewis-Thames MW. Rural-urban differences in personality traits and well-being in adulthood. J Pers. 2024;92(1):73–87. https://doi.org/10.1111/jopy.12818 .

Anthony M. Editorial: nursing shortage. Home Healthc Now. 2024;42(1):5. https://doi.org/10.1097/NHH.0000000000001233 .

China Health Statistics Yearbook. (2022). http://www.nhc.gov.cn/mohwsbwstjxxzx/tjtjnj/202305/6ef68aac6bd14c1eb9375e01a0faa1fb/files/b05b3d958fc546d98261d165cea4adba.pdf Assessed 14 April 2024.

Ross J. Nursing shortage creating patient safety concerns. J Perianesthesia Nurs. 2022;37(4):565–7. https://doi.org/10.1016/j.jopan.2022.05.078 .

Laranjeira C, Carvalho P, Querido A. Digital Storytelling: art-based pedagogy to improve professional development for nurses. J Contin Educ Nurs. 2021;52(10):454–6. https://doi.org/10.3928/00220124-20210913-04 .

Orr FR. (2017). I know how it feels: A voice-hearing simulation to enhance nursing students’ empathy and self-efficacy (Doctoral dissertation).

Chiona BC, Msiska M. The self-efficacy of Malawian nursing educators towards the use of case study teaching method. Malawi Med J. 2023;35(2):89–94. https://doi.org/10.4314/mmj.v35i2.3 .

Chang WP. How social support affects the ability of clinical nursing personnel to cope with death. Appl Nurs Res. 2018;44:25–32. https://doi.org/10.1016/j.apnr.2018.09.005 .

Artioli G, Foà C, Taffurelli C. An integrated narrative nursing model: towards a new healthcare paradigm. Acta bio-medica. 2016;87(4–S):13–22.

PubMed   Google Scholar  

Download references

This study was funded by the National Natural Science Foundation of China (No. 22BGL317).

Author information

Authors and affiliations.

Department of Geriatric Digestive Surgery, The Second Affiliated Hospital of Xi’an Jiaotong University, Xi’an, Shaanxi Province, China

Li Zhang & Qiang Han

Cancer Center, The First Affiliated Hospital of Xi’an Jiaotong University, Xi’an, Shaanxi Province, China

Nursing Department, The Second Affiliated Hospital of Xi’an Jiaotong University, Xi’an, Shaanxi Province, China

Huiyun Yang

You can also search for this author in PubMed   Google Scholar

Contributions

L Z conceptualized and designed the study, developed the methodology, implemented software tools, and drafted the original manuscript. Q H and L N conducted investigations, curated data, contributed to conceptualization and methodology, and drafted the original manuscript. HY provided supervision, validated the findings, and contributed to writing, reviewing, and editing the manuscript. All authors have approved the final draft.

Corresponding author

Correspondence to Huiyun Yang .

Ethics declarations

Ethical approval and consent to participate, consent for publication.

Not applicable.

Competing interests

The authors declare no competing interests.

Additional information

Publisher’s note.

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Rights and permissions

Open Access This article is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License, which permits any non-commercial use, sharing, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if you modified the licensed material. You do not have permission under this licence to share adapted material derived from this article or parts of it. The images or other third party material in this article are included in the article’s Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article’s Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by-nc-nd/4.0/ .

Reprints and permissions

About this article

Cite this article.

Zhang, L., Han, Q., Nan, L. et al. Impact of narrative nursing cognition, self-efficacy, and social support on the practices of registered nurses in China: a structural equation modeling analysis. BMC Nurs 23 , 624 (2024). https://doi.org/10.1186/s12912-024-02292-2

Download citation

Received : 03 June 2024

Accepted : 26 August 2024

Published : 05 September 2024

DOI : https://doi.org/10.1186/s12912-024-02292-2

Share this article

Anyone you share the following link with will be able to read this content:

Sorry, a shareable link is not currently available for this article.

Provided by the Springer Nature SharedIt content-sharing initiative

• Narrative nursing
• Self-efficacy
• Social support
• Registered nurses

BMC Nursing

ISSN: 1472-6955

• General enquiries: [email protected]

Log in using your username and password

• Search More Search for this keyword Advanced search
• Latest content
• Current issue
• Write for Us
• BMJ Journals

You are here

• Online First
• Embracing diversity in nursing research: essential tips
• Article Text
• Article info
• Citation Tools
• Rapid Responses
• Article metrics

• Lorna Hollowood 1 ,
• Calvin Moorley 2
• 1 University of Birmingham , Birmingham , UK
• 2 London South Bank University School of Health and Social Care , London , UK
• Correspondence to Lorna Hollowood; L.hollowood{at}bham.ac.uk

https://doi.org/10.1136/ebnurs-2024-104183

Statistics from Altmetric.com

Request permissions.

If you wish to reuse any or all of this article please use the link below which will take you to the Copyright Clearance Center’s RightsLink service. You will be able to get a quick price and instant permission to reuse the content in many different ways.

Nursing is a profession that has always worked with diverse people and communities and has taken a social justice approach to care. Nursing has also undertaken research that includes diverse groups and communities. However, nurse researchers working with and undertaking research with diverse groups and communities may encounter problems in executing the research. This may be for reasons such as poor understanding of cultural and racial difference, not having an inclusive research team, for example, LGBTQIA+ researchers to help conduct LGBTQIA+ focused research or using an ableist approach, all of which can lead to exclusion, diminished trust and credibility. In this commentary, we draw on Hollowood’s doctoral journey and Moorley’s research experience, where both work with and research diverse communities’ health. Nurse researchers need to apply methodologies and approaches that are culturally sensitive and inclusive and here we offer essential tips, which have helped us by drawing on culturally specific and diversity-sensitive methods and frameworks to support inquiries which aim to improve the situation of the diverse communities nursing serves.

Choosing culturally sensitive theoretical frameworks and methodologies

Whiteness has dominated nursing, 1 and this also extends to nursing research where dominant western philosophies and methodologies are applied. Nurse researchers have not had many culturally and racially sensitive frameworks to choose from and so their research on, for example, race and culture has mainly used frameworks framed on whiteness and this can lead to health and care being interpreted, analysed and recommendations made based on white lens. One of the frameworks we advocate for is The Silences Framework. 2 It is a powerful tool to help uncover and understand marginalised discourses in research. This framework explicitly supports the researcher to identify and address the ‘silences’ which sit within a group and impact on their experiences and perspectives. ‘Silences’ refers to the areas of research that we know little about, …

Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

Competing interests None declared.

Provenance and peer review Commissioned; internally peer reviewed.

Read the full text or download the PDF:

• Subscribe to journal Subscribe
• Get new issue alerts Get alerts

Secondary Logo

Journal logo.

Colleague's E-mail is Invalid

Your message has been successfully sent to your colleague.

Save my selection

The Art of Healthy Aging

Moffa, Christine PhD, RN, APRN, PMHNP-BC

AJN Senior Clinical EditorEmail: [email protected]

It's never too early to think about growing older.

September is National Healthy Aging Month. The observance began in 1992, four years before the oldest baby boomers would turn 50, and was recognized in 2021 by the U.S. Senate, with the goal of promoting a positive view of growing older. It's never too early to think about healthy aging, and as we're technically all aging by the minute, it should be of interest to everyone. While genetics play a role in healthy aging, lifestyle choices also factor in. In addition to exercise and healthy eating for physical well-being, the National Institutes of Health (NIH) also recommends ways to preserve one's mental health (for more, see www.nia.nih.gov/health/healthy-aging/what-do-we-know-about-healthy-aging ).

One way is by maintaining social connections. It's easy to forget about your social life when you're working a demanding job and coming home physically and mentally exhausted, or experiencing burnout and moral distress, as many nurses these days do. A few years ago, I was working on my PhD (which can be very isolating), which focused on workplace mistreatment of nurses. As you can imagine, being immersed in this topic for years and writing a dissertation on it can start to wear on you. I remember telling people, “If I could do this all again, I would prefer a more uplifting topic, like ‘jokes people tell at cocktail parties.’” I was kidding, of course, and it didn't occur to me at the time that humor had a place in health care research. It turns out that it does, as seen in this month's original research article by Cadiz and colleagues, “Exploring Nurses' Use of Humor in the Workplace: A Thematic Analysis.”

Reading this article made me reflect on my own experience working in different health care settings and the role humor played in connecting with coworkers and patients. I look back fondly on memories of friends I made at work and how laughing with them helped ease the tension between difficult shifts. I also use humor when working with patients in my role as a psychiatric mental health NP. It can serve to break the ice or to provide encouragement and demonstrate the human side of the provider–patient relationship. Once, when a patient was describing their disappointment at not reaching a life milestone in the time they expected to, I shared how it took me seven years to get my associate degree, adding, “I'm a late bloomer, but I got there eventually!” We both laughed and it helped normalize their situation. It's important to note that using humor is like seasoning a recipe: it's there to make the conversation more interesting and memorable, but you need to know when to add it and when it might be too much of a good thing.

Another NIH recommendation for healthy aging is to participate in hobbies and leisure activities. On our cover is a painting by Ren Hernandez, a nurse who discovered his talent during the pandemic. The piece is called ephemeral snow , and the artist says it “showcases strength among adversity.” In an email, Hernandez shared with me that “art, colors, and self-expression are extremely therapeutic, and it was such a solace for me during the height of the pandemic. . . . Through my art, I want everyone to explore their own latent creativity and find therapeutic ways of combating stress.” And this month's Conversations highlights the work of MK Czerwiec, a nurse and cofounder of the field of graphic medicine, who draws comics to process her experiences in health care.

While humor, art, and other creative outlets for stress reduction are great ways to focus on keeping ourselves healthy, I want to be clear that they are in no way meant to be a panacea for short staffing or other forms of mistreatment of nurses. Self-care and resilience do not make up for an unsafe and unhealthy work environment. A Project Evaluation article in this issue examines an intervention for providing peer support to “second victims”—health care workers who have experienced a negative patient outcome. And In the News covers the impact (or lack thereof) of using a team nursing model as a potential solution for staffing demands. Finally, Legal Clinic provides information on how nurses protect their livelihood when they understand nurse licensure.

• + Favorites
• View in Gallery

Readers Of this Article Also Read

Evidence-based practice: step by step: the seven steps of evidence-based..., including the sustainable development goals in nursing scholarship, artificial intelligence and nursing: promise and precaution, the u.s. maternal health crisis, ‘forever chemicals’ in water supply more widespread than previously thought.

• Current Students
• Pre-College
• K-12 educators

Penn College News

Nursing students' capstones present clinical research

Thursday, April 25, 2024

Photos by Jennifer Cline, writer/magazine editor

Penn College nursing students presented their capstone projects on Tuesday, researching a variety of health conditions they saw while completing clinical education experiences in area hospitals, and exploring ways to improve a process they witnessed.

The 23 students – all preparing to complete their bachelor’s degrees after final exams next week – are enrolled in three courses that, in tandem, resulted in their capstone projects: Adult Health Nursing III, taught by Pamela W. Baker, associate professor of nursing (with labs co-taught at clinical sites by Baker and nursing instructors Gina L. Bross, Jessica A. Confer and Steve C. Sofopoulos); Leadership & Management in Nursing, taught by Donnamarie Lovestrand, assistant professor of nursing; and Research & Theory in Clinical Practice, taught by Barbie D. Harbaugh, assistant professor of nursing.

As the nursing industry – like others – seeks continuous improvement, the research, leadership and presentation skills practiced will be vital in the students’ work.

Four student groups addressed:

Research: Preventing Skin Breakdown Using Wedges vs. Pillows in Intubated Intensive Care Unit Patients Process improvement: Improve communication and team building by instituting shift huddles Students: Monica I. Boone, of South Williamsport; Hesakya Hoover, of Williamsport; Shelby Pyatt, of Frenchtown, N.J.; Miranda Schneider, of Williamsport; Kaelynn N. Sheetz, of Elizabethtown; and Allison M. Troup, of Huntingdon.  

Research: Liver Transplants with Healthy Liver vs. Liver with a Comorbidity Process improvement: Provide more education to nurses regarding organ donation Students : Felicia J. Baney, of Mill Hall; Maria Berardelli, of Montoursville; Jenna Hickok, of Williamsport; Nina Miller, of Pottsville; Austin J. Spotts, of Dalmatia; and Megan S. Twigg, of Montgomery.  

Research: Urinary Tract Infection Risk Assessment of Foley Catheters vs. External Catheters: A comparison Process improvement: Standardize the method for cleaning Foley catheters and provide consistent training to nurses Students: Madison C. Branstetter, of Tyrone; Kendra L. Rager, of Williamsport; Vanessa Reddick, of Sligo; Lisa Sever, of Montoursville; Aubrey Stetts, of Jersey Shore; and Madison S. Wells, of Muncy Valley.  

Research: Decreasing Alarm Fatigue in the ICU Setting (The alarms are those on monitoring equipment, such as ventilators and cardiac monitors.) Process improvement: Improve response time to reduce the stress of nurses and improve patient outcomes.  Students: Dana P. Clements, of Cleona; Sadie V. Kerstetter, of Loganton; Ashlyn R. Leo, of Benton; Katharine M. Noss, of Shickshinny; and Krysta Windnagle, of Addison, N.Y.

Get Penn College News in your inbox each morning.

The future needs you

If you put more into today, could you get more out of tomorrow? If you create your future at Pennsylvania College of Technology, the answer is yes.

With open and rolling admission, applying is easy.

Experience all that campus has to offer with visit options designed just for you.

Get more information about the admission process.

Skip to Main Content

How to Get Into Nursing School: 7 Steps for Success

July 02, 2024 - 7 minute read

Nursing is a career unlike any other. The general public highly respects nurses , and with good reason. Nurses make it their life’s work to help others. If you’re considering a career switch, why not become a nurse?

Nursing offers diverse specialties — from oncology to pediatrics and beyond — and room for advancement. Plus, according to the U.S. Bureau of Labor Statistics , it boasts a consistently high job growth rate and excellent salary potential. What’s more, getting started can be easier than you might think.

At Concordia University Irvine, our Accelerated Bachelor of Science in Nursing (ABSN) program helps make the transition to nursing possible. Our ABSN program prepares students to become caring, compassionate, competent nurses, ready to serve their community.

Let’s take a closer look at how to get into nursing school as a transfer student or career switcher. 

1. Determine if You Qualify for Accelerated Nursing School

To qualify for the National Council Licensure Examination for Registered Nurses (NCLEX-RN®), you need to earn a nursing degree, such as a Bachelor of Science in Nursing (BSN). The BSN degree is traditionally a four-year program that combines core college classes (such as English and math) with the nursing curriculum. However, if you’re a transfer student or an established professional thinking of transitioning to a new career, you may be able to graduate sooner.

You can apply for an accelerated BSN program if you meet the qualifications. These programs confer a BSN in far less than four years. Most ABSN programs take less than two years to complete; for example, Concordia University Irvine’s ABSN allows you to graduate in as few as 15 months.

Imagine the benefits of graduating with your nursing degree in as few as 15 months. Graduating sooner means you can begin earning a nursing salary and contribute to your community faster than with a traditional BSN program.

However, before applying to an accelerated nursing program, you’ll need to confirm that you meet the qualifications. Each ABSN program has its own admissions requirements, but, in general, you'll need a non-nursing bachelor's degree or a minimum number of non-nursing college credits. There are also typically minimum GPA requirements. 

Concordia University Irvine’s ABSN program admissions requirements include a Bachelor of Science or Bachelor of Arts degree in any discipline or a minimum of 65 non-nursing college credits from an accredited institution. You must also have a minimum cumulative GPA of 3.25 (on a 4.0 scale).

To determine whether you qualify for Concordia’s ABSN program, contact one of our specialized admissions counselors, who will walk you through the application process and ensure your application is competitive.

2. Research Your Nursing School Options

When determining how to get into nursing school, such as an ABSN program, you should research your options thoroughly. What should you look for in a nursing school? 

Here are a few factors to consider:

• Accreditation
• NCLEX pass rate
• Dedication of the faculty
• Nursing philosophy and mission

You’ll want to choose an accelerated nursing program with a recomprehensive curriculum covering everything you need to succeed as a licensed registered nurse, from pathophysiology to nursing research, and beyond. A challenging curriculum will more thoroughly prepare you to tackle the modern challenges you’ll encounter in your nursing career.

A school’s nursing philosophy and mission may also influence which program is right for you. At Concordia University Irvine, our ABSN program is informed by Christian values and founded on the mission to provide students with the knowledge and skills needed to become competent and compassionate nurses. 

3. Reach Out to an Admissions Counselor

Once you’ve settled on the right nursing school, you can begin the actual work of getting into nursing school by contacting an admissions counselor. It’s best to have a copy of your unofficial transcripts on hand, as your counselor will review your prior non-nursing college credits to determine eligibility.

You should also have a list of any questions about the program. Before concluding the call, your admissions counselor will help you put together a plan for applying based on your current situation. That application plan may include taking some prerequisite courses.

4. How to Get into Nursing School by Completing Prerequisites

Not every prospective nursing student needs to complete the prerequisite courses. It ultimately depends on your prior college education. Prerequisites are often required to ensure that nursing students begin the program with a solid academic foundation. It’s essentially a success strategy designed to support your progress.

Concordia’s ABSN program requires prerequisites such as chemistry, microbiology, statistics, and lifespan development psychology. As a Christian school, we also require courses in Christian Theology and the New Testament.

[CALLOUT: Wondering how to become a nurse online ? Read more to learn what to expect.]

5. Gain Entry-Level Experience in Patient Care

While you’re completing prerequisite courses, it’s a good idea to gain entry-level experience in the healthcare field. Having some experience can help your nursing school application stand out from the rest. Furthermore, some ABSN schools, such as Concordia University Irvine, require it. To apply to our ABSN, you’ll need at least 75 hours of patient care experience to be completed at the time of submitting an application. 

You can’t work as an RN just yet, of course, but there are other possibilities to explore, such as the following:

• Certified Nursing Assistant (CNA)
• COPE Health Scholar/Clinical Care Extender
• Emergency Medical Technician (EMT)
• Medical Assistant (back office)
• Home Health Aide
• Physical Therapy (PT) Aid

6. Complete and Submit Your Application Package

Once you’ve completed the required courses and obtained patient care experience hours, you should be ready to finish your application package. Your admissions counselor will be an invaluable resource as you assemble your materials. 

At Concordia, you can submit your application prior to completing the prerequisite classes if you only have three remaining and they are in progress.

Each school has different requirements for its application package. At Concordia, the application materials include:

• The application itself, plus the fee
• Statement of intent/essays
• Background check waiver form
• Two letters of recommendation
• Official college transcripts

7. Research Financial Aid Options for Nursing School

Now that we have established how to get into nursing school, the next step is to research financial aid options . Fill out the Free Application for Federal Student Aid (FAFSA) for each year you’re a student to determine what federal aid you qualify for, such as federal grants and student loans. You should also look into private student loans and apply for any eligible scholarships.

Quick Tips for Getting into Nursing School

By this point, you know how to get into nursing school, but you can do a few other things to increase your chances of success. 

Consider the following quick tips:

• Always re-read the application instructions for each component of your application package and follow them to the letter.
• Don’t hesitate to reach out to your admissions counselor if you have any questions. You can even ask for tips on making a competitive application.
• Take your time with the essay questions. Your essays should reflect your unique voice and genuine goal of becoming a nurse. However, they should also be well-edited. After writing your essays, set them aside for a few days and re-read with fresh eyes.
• Get certified in cardiopulmonary resuscitation (CPR) at the American Red Cross.
• Gain volunteer experience in the healthcare field.

[CALLOUT: What was nursing like at the height of the COVID pandemic? Explore one Concordia alumna’s story in frontline nursing .]

Apply Today at Concordia University Irvine

At Concordia, we make getting into nursing school easier with help from our specialized admissions counselors, who will take the time to work with you one-on-one throughout the admissions process and answer all your questions .

We welcome transfer students and military members to apply to our ABSN program, which allows you to graduate in as few as 15 months.

Our dedicated nursing instructors strive to graduate highly competent and compassionate future nurses who stand out for their dedication to their patients’ welfare. Take the first step toward becoming a registered nurse today and contact our admissions counselors .

Join Our Community

• Systematic Review
• Open access
• Published: 30 August 2024

A scoping review of stroke services within the Philippines

• Angela Logan 1 , 2 ,
• Lorraine Faeldon 3 ,
• Bridie Kent 1 , 4 ,
• Aira Ong 1 &
• Jonathan Marsden 1  

BMC Health Services Research volume  24 , Article number:  1006 ( 2024 ) Cite this article

2 Altmetric

Metrics details

Stroke is a leading cause of mortality and disability. In higher-income countries, mortality and disability have been reduced with advances in stroke care and early access to rehabilitation services. However, access to such services and the subsequent impact on stroke outcomes in the Philippines, which is a lower- and middle-income countries (LMIC), is unclear. Understanding gaps in service delivery and underpinning research from acute to chronic stages post-stroke will allow future targeting of resources.

This scoping review aimed to map available literature on stroke services in the Philippines, based on Arksey and O’Malley’s five-stage-process.

Summary of review

A targeted strategy was used to search relevant databases (Focused: MEDLINE (ovid), EMBASE (ovid), Cumulative Index to Nursing and Allied Health Literature (CINAHL), PsycINFO (ebsco); broad-based: Scopus; review-based: Cochrane Library, International Prospective Register of Systematic Reviews (PROSPERO), JBI (formerly Joanna Briggs Institute) as well as grey literature (Open Grey, Google scholar). The searches were conducted between 12/2022-01/2023 and repeated 12/2023. Literature describing adults with stroke in the Philippines and stroke services that aimed to maximize well-being, participation and function were searched. Studies were selected if they included one or more of: (a) patient numbers and stroke characteristics (b) staff numbers, qualifications and role (c) service resources (e.g., access to a rehabilitation unit) (d) cost of services and methods of payment) (e) content of stroke care (f) duration of stroke care/rehabilitation and interventions undertaken (g) outcome measures used in clinical practice.

A total of 70 papers were included. Articles were assessed, data extracted and classified according to structure, process, or outcome related information. Advances in stroke services, including stroke ready hospitals providing early access to acute care such as thrombectomy and thrombolysis and early referral to rehabilitation coupled with rehabilitation guidelines have been developed. Gaps exist in stroke services structure (e.g., low number of neurologists and neuroimaging, lack of stroke protocols and pathways, inequity of stroke care across urban and rural locations), processes (e.g., delayed arrival to hospital, lack of stroke training among health workers, low awareness of stroke among public and non-stroke care workers, inequitable access to rehabilitation both hospital and community) and outcomes (e.g., low government insurance coverage resulting in high out-of-pocket expenses, limited data on caregiver burden, absence of unified national stroke registry to determine prevalence, incidence and burden of stroke). Potential solutions such as increasing stroke knowledge and awareness, use of mobile stroke units, TeleMedicine, TeleRehab, improving access to rehabilitation, upgrading PhilHealth and a unified national long-term stroke registry representing the real situation across urban and rural were identified.

This scoping review describes the existing evidence-base relating to structure, processes and outcomes of stroke services for adults within the Philippines. Developments in stroke services have been identified however, a wide gap exists between the availability of stroke services and the high burden of stroke in the Philippines. Strategies are critical to address the identified gaps as a precursor to improving stroke outcomes and reducing burden. Potential solutions identified within the review will require healthcare government and policymakers to focus on stroke awareness programs, primary and secondary stroke prevention, establishing and monitoring of stroke protocols and pathways, sustainable national stroke registry, and improve access to and availability of rehabilitation both hospital and community.

What is already known?

Stroke services in the Philippines are inequitable, for example, urban versus rural due to the geography of the Philippines, location of acute stroke ready hospitals and stroke rehabilitation units, limited transport options, and low government healthcare insurance coverage resulting in high out-of-pocket costs for stroke survivors and their families.

What are the new findings?

The Philippines have a higher incidence of stroke in younger adults than other LMICs, which impacts the available workforce and the country’s economy. There is a lack of data on community stroke rehabilitation provision, the content and intensity of stroke rehabilitation being delivered and the role and knowledge/skills of those delivering stroke rehabilitation, unmet needs of stroke survivors and caregiver burden and strain,

What do the new findings imply?

A wide gap exists between the availability of stroke services and the high burden of stroke. The impact of this is unclear due to the lack of a compulsory national stroke registry as well as published data on community or home-based stroke services that are not captured/published.

What does this review offer?

This review provides a broad overview of existing evidence-base of stroke services in the Philippines. It provides a catalyst for a) healthcare government to address stroke inequities and burden; b) development of future evidence-based interventions such as community-based rehabilitation; c) task-shifting e.g., training non-neurologists, barangay workers and caregivers; d) use of digital technologies and innovations e.g., stroke TeleRehab, TeleMedicine, mobile stroke units.

Peer Review reports

Introduction

In the Philippines, stroke is the second leading cause of death, with a prevalence of 0·9% equating to 87,402 deaths per annum [ 1 , 2 ]. Approximately 500,000 Filipinos will be affected by stroke, with an estimated US$350 million to $1·2 billion needed to meet the cost of medical care [ 1 ]. As healthcare is largely private, the cost is borne out-of-pocket by patients and their families. This provides a major obstacle for the lower socio-demographic groups in the country.

Research on implementation of locally and regionally adapted stroke-services and cost-effective secondary prevention programs in the Philippines have been cited as priorities [ 3 , 4 ]. Prior to developing, implementing, and evaluating future context-specific acute stroke management services and community-based models of rehabilitation, it was important to map out the available literature on stroke services and characteristics of stroke in the Philippines.

The scoping review followed a predefined protocol, established methodology [ 5 ] and is reported according to the Preferred Reporting Items for Systematic Review and Meta-Analyses Extension for Scoping Reviews Guidelines (PRISMA-ScR) [ 6 , 7 ]. Healthcare quality will be described according to the following three aspects: structures, processes, and outcomes following the Donabedian model [ 8 , 9 ].The review is based on Arksey and O'Malley’s five stages framework [ 5 ].

Stage 1: The research question:

What stroke services are available for adults within the Philippines? The objective was to systematically scope the literature to describe the availability, structure, processes, and outcome of stroke services for adults within the Philippines.

Stage 2: Identifying relevant studies:

The following databases were searched. Focused: MEDLINE, EMBASE, Cumulative Index to Nursing and Allied Health Literature (CINAHL), PsycINFO; broad-based: Scopus; review-based: Cochrane Library, Prospero, JBI (formerly Joanna Briggs Institute); Grey literature: Herdin, North Grey, Grey matters, MedRxiv, NIHR health technology assessment, Department of Health Philippines, The Kings Fund, Ethos, Carrot2. Additionally, reference lists of full text included studies were searched.

The targeted search strategy, developed in consultation with an information scientist, was adapted for each database (see supplemental data). Search terms were peer reviewed using the PRESS (Peer Review of Electronic Search Strategies) checklist [ 10 ].

The key search concepts from the Population, Concept and Context (PCC) framework were ≥ 18 years with a stroke living in the Philippines ( population ), stroke services aiming to maximize well-being, participation and function following a stroke ( concept ) and stroke services from acute to chronic including those involving healthcare professionals, non-healthcare related personnel or family or friends ( context ). Search tools such as medical subject headings (MESH) and truncation to narrow or expand searches were used. Single and combined search terms were included (see supplemental data). The search was initially conducted over two weeks in December 2022 and re-run in December 2023.

Studies were selected if they described stroke care in the Philippines in terms of one or more of the following: (a) patient numbers and stroke characteristics (b) staff numbers, qualifications and role (c) service resources (e.g., number of beds/access to a rehabilitation unit, equipment used) (d) cost of services and methods of payment (UHC, Insurance, private) (e) content of stroke care (f) duration of stroke care (hours of personnel contact e.g., Therapy hours per day); interventions undertaken (g) outcome measures used in clinical practice.

Additional criteria:

Context: all environments (home, hospital, outpatients, clinic, academic institute).

Date limits: published between 2002 onwards. This is based on the Philippines Community Rehabilitation Guidelines published in 2009 that would suggest that papers earlier than 2002 may not reflect current practice [ 11 ].

Qualitative and quantitative studies including grey literature.

Language: reported in English or Filipino only.

Publication status: no limit because the level of rigor was not assessed.

Type of study: no limit which included conference abstracts, as the level of rigor was not assessed.

Studies were excluded if they were in non-stroke populations or the full text article could not be obtained. Conference abstracts were excluded if there were insufficient data about methods and results.

Searches of databases were performed by one researcher (JM) and searches of grey literature were performed by one researcher (AO). All retrieved articles were uploaded into Endnote X9 software™, and duplicates identified and removed before transferring them to Rayyan [ 12 ] for screening.

Stage 3: study selection

The title and abstract were selected using eligibility criteria. Two pairs of researchers independently screened abstracts and titles;(Databases: JM and AL and grey literature by AO and LF). Where a discrepancy existed for title and abstract screening, the study was automatically included for full text review and discussed among reviewers.

Two reviewers (JM and AL) undertook full-text screening of the selected studies. Discrepancies were resolved through consensus discussions without the need for a third reviewer. There were no discrepancies that required a third reviewer. Reason for exclusion were documented according to pre-determined eligibility criteria. References of included full text articles were screened by each reviewer independently and identified articles were subjected to the same screening process as per the PRISMA-ScR checklist (Fig.  1 ).

PRISMA-ScR flow diagram

Stage 4: Charting the data

Two reviewers independently extracted the data using a piloted customized and standardized data extraction form including (1) Structure: financial (e.g., costs, insurance, government funding), resources (structure and number of stroke facilities, staff (number, profession/specialism, qualifications etc.), stroke characteristics (2) Process: duration of care, content of stroke care within acute, secondary care, community, outcome measures used; (3) Outcome: survival, function, patient satisfaction, cost (admission and interventions), and (4) year of publication, geographical location (including if Philippines only or multiple international locations) and type of evidence (e.g., policy, review, observational, experimental, clinical guidelines). Critical appraisal of included studies was not undertaken because the purpose of the review was to map available evidence on stroke services available within the Philippines.

Stage 5: Collating, summarising and reporting the results

The search identified 351 records from databases and registers. A total of 70 records are included and reasons for non-inclusion are summarized in Fig.  1 .

Study descriptors

The characteristics of included studies are shown in Supplementary Material Table 1. Of the 70 included studies, 36 were observational with most being based on a retrospective review of case notes ( n  = 31), two were audits, eight were surveys or questionnaires, four were consensus opinion and/or guideline development, three were randomized controlled trial (RCT) or feasibility RCT, 1 was a systematic review, two were policy and guidelines, 11 were narrative reviews or opinion pieces, two were case series or reports and one was an experimental study.

Of the 70 studies, 32 (45.7%) were based in a single tertiary hospital site. There were only three papers based in the community (4.3%). Papers that were opinion pieces or reviews were classified as having a national focus. Of the 22 papers classified as having a national focus, 10 (45.5%) were narrative reviews/ opinion pieces (Table 1 ).

The primary focus of the research studies (excluding the 11 narrative reviews and 2 policy documents) were classified as describing structure ( n  = 8, 14%); process ( n  = 21,36.8%) or outcomes ( n  = 29, 49.2%). The structure of acute care was described in seven studies out of eight studies ( n  = 7/8 87.5%) whilst neurosurgery structures were described in one out of eight studies (12.5%). Acute care processes were described in 11 out of 21 studies ( n  = 11/21 52.3%) whilst rehabilitation processes were described in six out of 21 studies (28.6%), with three out of 21 studies primarily describing outcome measurement (14.3%). The primary focus of the outcomes were stroke characteristics (25 out of 28 papers, 89.2%) in terms of number of stroke (prevalence), mortality or severity of stroke. Measures of stroke quality of life were not reported. Healthcare professional knowledge was described in two studies ( n  = 2/28 7.1%) whilst risk factors for stroke were described in one study ( n  = 1/28, 3.6%). Carer burden was described in one study ( n  = 1/28, 3.6%).

A summary of the findings is presented in Table 2 .

This scoping review describes the available literature on stroke services within the Philippines across the lifespan of an adult (> 18 years) with a stroke. The review has identified gaps in information about structures, processes and outcomes as well as deficits in provision of stroke services and processes as recommended by WHO. These included a low number of specialist clinicians including neurologists, neuro-radiographers and neurosurgeons. The high prevalence of stroke suggests attention and resources need to focus on primary and secondary prevention. Awareness of stroke is low, especially in terms of what a stroke is, the signs/symptoms and how to minimize risk of stroke [ 25 ]. Barriers exist, such as lack of healthcare resources, maldistribution of health facilities, inadequate training on stroke treatment among health care workers, poor stroke awareness, insufficient government support and limited health insurance coverage [ 22 ].

The scoping review also highlighted areas where further work is needed, for example, descriptions and research into the frequency, intensity, and content of rehabilitation services especially in the community setting and the outcome measures used to monitor recovery and impairment. PARM published stroke rehabilitation clinical practice guidelines in 2012, which incorporated an innovative approach to contextualize Western clinical practice guidelines for stroke care to the Philippines [ 42 ]. Unfortunately, availability and equitable access to evidence-based rehabilitation for people with stroke in the Philippines pose significant challenges because of multiple factors impacting the country (e.g., geographical, social, personal, environmental, educational, economic, workforce) [ 25 , 40 , 43 ].

The number of stroke survivors with disability has not been reported previously, thus, the extent and burden of stroke from acute to chronic is unknown. The recent introduction of a national stroke registry across public and private facilities may provide some of this data [ 82 ]. The project started in 2021 and captures data on people hospitalized for transient ischemic attack or stroke in the Philippines. National stroke registries have been identified as a pragmatic solution to reduce the global burden of stroke [ 83 ] through surveillance of incidence, prevalence, and outcomes (e.g., death, disability) of, and quality of care for, stroke, and prevalence of risk factors. For the Philippine government to know the full impact and burden of stroke nationally, identify areas for improvement and make meaningful changes for the benefit of Filipinos, the registry would need to be compulsory for all public and private facilities and include out of hospital data. This will require information technology, trained workforces for data capture, monitoring and sharing, as well as governance and funding [ 83 ].

This scoping review has generated a better understanding of the published evidence focusing on availability of stroke services in the Philippines, as well as the existing gaps through the lens of Donabedian’s Structure , Process and Outcome framework. The findings have helped to inform a wider investigation of current stroke service utilization conducted using survey and interview methods with stroke survivors, carers and key stakeholders in the Philippines, and drive forward local, regional and national policy and service changes.

Conclusions

This scoping review describes the existing evidence-based relating to structure, processes and outcomes of stroke services for adults within the Philippines. The review revealed limited information in certain areas, such as the impact of stroke on functional ability, participation in everyday life, and quality of life; the content and intensity of rehabilitation both in the hospital or community setting; and the outcome measures used to evaluate clinical practice. Developments in stroke services have been identified however, a wide gap exists between the availability of stroke services and the high burden of stroke in the Philippines. Strategies are critical to address the identified gaps as a precursor to improving stroke outcomes and reducing burden. Potential solutions identified within the review will require a comprehensive approach from healthcare policymakers to focus on stroke awareness programs, primary and secondary prevention, establishing and monitoring of stroke protocols and pathways, implementation of a compulsory national stroke registry, use of TeleRehab, TeleMedicine and mobile stroke units and improve access to and availability of both hospital- and community-based stroke rehabilitation. Furthermore, changes in PhilHealth coverage and universal credit to minimize catastrophic out-of-pocket costs.

Limitations

Although a comprehensive search was undertaken, data were taken from a limited number of located published studies on stroke in the Philippines. This, together with data from databases and grey literature, may not reflect the current state of stroke services in the country.

Availability of data and materials

Not applicable.

Data availability

No datasets were generated or analysed during the current study.

Navarro JC, Baroque AC, Lokin JK, Venketasubramanian N. The real stroke burden in the Philippines. Int J Stroke. 2014;9(5):640–1.

Article   PubMed   Google Scholar  

Philippines TSSot. Phillipines: stroke 2024. Available from: https://www.strokesocietyphilippines.org/philippines-stroke/#:~:text=Stroke%20is%20the%20Philippines'%20second,or%2014.12%25%20of%20total%20deaths .

Banaag MS, Dayrit MM, Mendoza RU. Health Inequity in the Philippines. In: Batabyal A, Higano Y, Nijkamp P (eds). Disease, Human Health, and Regional Growth and Development in Asia. New Frontiers in Regional Science: Asian Perspectives, vol 38. Singapore: Springer; 2019.

Hodge A, Firth S, Bermejo R, Zeck W, Jimenez-Soto E. Utilisation of health services and the poor: deconstructing wealth-based differences in facility-based delivering in teh Philippines. BMC Public Health. 2016;16:1–12.

Arksey H, O’Malley L. Scoping studies: towards a methodological framework. Int J Soc Res Methodol. 2005;8:19–32.

Article   Google Scholar  

Tricco AC, Lillie E, Zarin W, O’Brien KK, Colquhoun H, Levac D, et al. PRISMA extension for scoping reviews (PRISMA-ScR): checklist and explanation. Ann Intern Med. 2018;169(7):467–73.

Levac D, Colquhoun H, O’Brien KK. Scoping studies: advancing the methodology. Implement Sci. 2010;5:69.

Article   PubMed   PubMed Central   Google Scholar  

Donabedian A. The quality of care. How can it be assessed? JAMA. 1988;260(12):1743–8.

Article   CAS   PubMed   Google Scholar  

McDonald KM, Sundaram V, Bravata DM, Lewis R, Lin N, Kraft SA, et al. Closing the quality gap: a critical analysis of quality improvement strategies. Tech Rev. 2007;7(9).

McGowan J, Sampson M, Salzwedel DM, Cogo E, Foerster V, Lefebvre C. PRESS peer review of electronic search strategies: 2015 guideline statement. J Clin Epidemiol. 2016;75:40–6.

McGlade B, Mendoza VE. Philippines CBR manual: an inclusive development strategy. Philippines: CBM-CBR Coordinating office; 2009.

Ouzzani M, Hammady H, Fedorowicz Z, et al. Rayyan—a web and mobile app for systematic reviews. Syst Rev. 2016;5(210). https://doi.org/10.1186/s13643-016-0384-4 .

Baliguas B. Adherence to the clinical practice guidelines of the stroke society of the Philippines in the management of ischemic stroke in young adults admitted in 3 tertiary hospitals in Bacolod City, Philippines from May to October 2010. Neurology. 2018;90(15).

Barcelon EA, Moll MAKDN, Serondo DJ, Collantes MEV. Validation of the Filipino version of national institute of health stroke scale. Clinical Neurology. 2016;56:S379.

Google Scholar  

Baticulon RE, Lucena LLN, Gimenez MLA, Sabalza MN, Soriano JA. The Neurosurgical Workforce of the Philippines. Neurosurgery. 2024;94(1):202–11. https://doi.org/10.1227/neu.0000000000002630 .

Berroya RM. Incidence of symptomatic intracerebral hemorrhage after thrombolysis for acute ischemic stroke at St. Luke’s Medical Center-Global City from January 2010 to February 2017. J Neurol Sci. 2010;2017(381):398–9.

Carcel C, Espiritu-Picar R. Circadian variation of ischemic and hemorrhagic strokes in adults at a tertiary hospital: a retrospective study. J Neurol Sci. 2009;285:S174.

Cayco CS, Gorgon EJR, Lazaro RT. Proprioceptive neuromuscular facilitation to improve motor outcomes in older adults with chronic stroke. Neurosciences (Riyadh). 2019;24(1):53–60.

Co COC, Yu JRT, Macrohon-Valdez MC, Laxamana LC, De Guzman VPE, Berroya-Moreno RMM, et al. Acute stroke care algorithm in a private tertiary hospital in the Philippines during the COVID-19 pandemic: a third world country experience. J Stroke Cerebrovasc Dis. 2020;29(9):105059.

Co COC, Yu JRT, Laxamana LC, David-Ona DIA. Intravenous thrombolysis for stroke in a COVID-19 positive Filipino patient, a case report. J Clin Neurosci. 2020;77:234–6.

Article   CAS   PubMed   PubMed Central   Google Scholar  

Collantes ME. Evaluation of change in stroke care in the Philippines using RES-Q data. Eur Stroke J. 2019;4:318.

Collantes ME. Improving stroke systems of care in lmic: Philippines. Int J Stroke. 2021;16(2):4.

Collantes ME, Navarro J, Belen A, Gan R. Stroke systems of care in the Philippines: addressing gaps and developing strategies. Front Neurol. 2022;13:1046351.

Collantes MEV, Yves Miel H, Zuñiga Uezono DR. Incidence and prevalence of stroke and its risk factors in the Philippines: a systematic review. Acta Medica Philippina. 2022;56:26–34.

Collantes MV, Zuniga YH, Granada CN, Uezono DR, De Castillo LC, Enriquez CG, et al. Current state of stroke care in the Philippines. Front Neurol. 2021;12:665086.

Constantino GA, Soliven JA. Points of in-hospital delays in thrombolytic therapy among patients with acute ischemic stroke: a single center 5-year retrospective study. Neurology. 2020;94(15).  https://doi.org/10.1212/WNL.94.15_supplement.2901 .

Constantino GAA, Señga MMA, Soliven JAR, Jocson VED. Emerging Utility of Endovascular Thrombectomy in the Philippines: A Single-center Clinical Experience. Acta Med Philipp [Internet]. 2023;57(5). Available from: https://actamedicaphilippina.upm.edu.ph/index.php/acta/article/view/5113 . [cited 2024 Aug 21].

Dans AL, Punzalan FE, Villaruz MV. National Nutrition and Health Survey (NNHeS): atherosclerosis-related diseases and risk factors. Philipp J Intern Med. 2005;43:103–15.

De Castillo LL, Collantes ME. Thrombolysis for stroke at the Philippine general hospital: a descriptive analysis. Cerebrovasc Dis. 2019;48:54.

de Castillo LLC, Diestro JDB, Tuazon CAM, Sy MCC, Añonuevo JC, San Jose MCZ. J Stroke Cerebrovasc Dis. 2021;30(7):105831.

Delfino JPM, Carandang-Chacon CA. Comparison of acute ischemic stroke care quality before and during the COVID-19 pandemic in a private tertiary hospital in metro Manila, Philippines. Neurol Asia. 2023;28(1):13–7.

Department of Health. Department of Health Administrative Order 2011-0003. 2011. [Accessed online: 12/2022], from the Philippine Department of Health].

Department of Health. The national policy framework on the prevention, control and management of acute stroke in the Philippines. 2020.

Diestro JDB, Omar AT, Sarmiento RJC, Enriquez CAG, Castillo LLC, Ho BL, et al. Cost of hospitalization for stroke in a low-middle-income country: Findings from a public tertiary hospital in the Philippines. Int J Stroke. 2021;16(1):39–42.

Duenas M, Ranoa G, Benjamin VS. Assessment of post-stroke caregivers’ burden through the modified caregivers strain index (MCSI) in a tertiary center in the Philippines: a cross-sectional study. Cerebrovasc Dis. 2019;48:56–7.

Duya JE, Hernandez K, San Jose MC. The evolving clinical and echocardiographic profile of patients admitted for acute cardioembolic stroke at a Tertiary Hospital in the Philippines. J Hong Kong Coll Cardiol. 2019;27(1):58.

Espiritu AI, San Jose MCZ. A call for a stroke referral network between primary care and stroke-ready hospitals in the philippines: a narrative review. Neurologist. 2021;26(6):253–60.

Gambito ED, Gonzalez-Suarez CB, Grimmer KA, Valdecañas CM, Dizon JM, Beredo ME, et al. Updating contextualized clinical practice guidelines on stroke rehabilitation and low back pain management using a novel assessment framework that standardizes decisions. BMC Res Notes. 2015;8:643.

Gelisanga MA, Gorgon EJ. Upright motor control test: interrater reliability, retest reliability, and concurrent validity in adults with subacute stroke. Eur Stroke J. 2017;2(1):357–8.

Gonzalez-Suarez C, Grimmer K, Alipio I, Anota-Canencia EG, Santos-Carpio ML, Dizon JM, et al. Stroke rehabilitation in the Philippines: an audit study. Disabil CBR Inclusive Develop. 2015;26(3):44–67.

Gonzalez-Suarez CB, Grimmer K, Cabrera JTC, Alipio IP, Anota-Canencia EGG, Santos-Carpio MLP, et al. Predictors of medical complications in stroke patients confined in hospitals with rehabilitation facilities: a Filipino audit of practice. Neurology Asia. 2018;23(3):199–208.

Gonzalez-Suarez CB, Grimmer-Somers K, Margarita Dizon J, King E, Lorenzo S, Valdecanas C, et al. Contextualizing Western guidelines for stroke and low back pain to a developing country (Philippines): an innovative approach to putting evidence into practice efficiently. J Healthc Leadersh. 2012;4:141–56.

Gonzalez-Suarez CB, Margarita J, Dizon R, Grimmer K, Estrada MS, Uyehara ED, et al. Implementation of recommendations from the Philippine Academy of Rehabilitation Medicine's Stroke Rehabilitation Guideline: a plan of action. Clin Audit. 2013;5:77–89.

Ignacio KHD, Diestro JDB, Medrano JMM, Salabi SKU, Logronio AJ, Factor SJV, et al. Depression and anxiety after stroke in young adult Filipinos. J Stroke Cerebrovasc Dis. 2022;31(2):106232.

Inting K, Canete MT. Ischemic stroke subtypes: a comparison between causative and phenotypic classifications in a tertiary hospital in the Philippines. Int J Stroke. 2021;16(2):28.

Jaca PKM, Chacon CAC, Alvarez RM. Clinical characteristics of cerebrovascular disease with COVID-19: a single-center study in Manila. Philippines Neurology Asia. 2021;26(1):15–25.

Jamora RDG, Corral EV, Ang MA, Epifania M, Collantes V, Gan R. Stroke recurrence among Filipino patients taking aspirin for first-ever non-cardioembolic ischemic stroke. Neurol Clin Neurosci. 2017;5:1–5.

Jamora RDG, Prado MB Jr, Anlacan VMM, Sy MCC, Espiritu AI. Incidence and risk factors for stroke in patients with COVID-19 in the Philippines: an analysis of 10,881 cases. J Stroke Cerebrovasc Dis. 2022;31(11).

Juangco DN, Mariano GS. Endovascular therapy for acute ischemic stroke: a review of cases and outcomes from a primary stroke center (a 5-year retrospective study). Cerebrovasc Dis. 2016;41:54.

Leochico CFD, Austria EMV, Gelisanga MAP, Ignacio SD, Mojica JAP. Home-based telerehabilitation for community-dwelling persons with stroke during the COVID-19 pandemic: a pilot study. J Rehabil Med. 2023;55:jrm4405.

Loo KW, Gan SH. Burden of stroke in the Philippines. Int J Stroke. 2013;8(2):131–4.

Mansouri A, Ku JC, Khu KJ, Mahmud MR, Sedney C, Ammar A, et al. Exploratory analysis into reasonable timeframes for the provision of neurosurgical care in low- and middle-income countries. World Neurosurg. 2018;117:e679–91.

Mendoza RA. The clinical profile and treatment outcome of acute ischemic stroke patients who underwent thrombolysis with recombinant tissue plasminogen activator therapy, Philippine experience: a retrospective study. J Neurol Sci. 2009;285:S85–6.

Navarro J. Prevalence of stroke: a community survey. Philipp J Neurol. 2005;9(2):11–5.

Navarro JC, Venketasubramanian N. Stroke burden and services in the Philippines. Cerebrovasc Dis Extra. 2021;11(2):52–4.

Navarro JC, Baroque AC 2nd, Lokin JK. Stroke education in the Philippines. Int J Stroke. 2013;8 Suppl A100:114–5.

Navarro JC, Chen CL, Lee CF, Gan HH, Lao AY, Baroque AC, et al. Durability of the beneficial effect of MLC601 (NeuroAiD™) on functional recovery among stroke patients from the Philippines in the CHIMES and CHIMES-E studies. Int J Stroke. 2017;12(3):285–91.

Navarro JC, Escabillas C, Aquino A, Macrohon C, Belen A, Abbariao M, et al. Stroke units in the Philippines: an observational study. Int J Stroke. 2021;16(7):849–54.

Navarro JC, San Jose MC, Collantes E, Macrohon-Valdez MC, Roxas A, Hivadan J, et al. Stroke thrombolysis in the Philippines. Neurol Asia. 2018;23(2):115.

Ng JC, Churojana A, Pongpech S, Vu LD, Sadikin C, Mahadevan J, et al. Current state of acute stroke care in Southeast Asian countries. Interv Neuroradiol. 2019;25(3):291–6.

Ocampo FF, De Leon-Gacrama FRG, Cuanang JR, Navarro JC. Profile of stroke mimics in a tertiary medical center in the Philippines. Neurol Asia. 2021;26(1):35–9.

Pascua R, Hiyadan JH. Outcome of decompressive hemicraniectomy without evacuation of hematoma in supratentorial intracerebral hemorrhage in a tertiary government hospital in the Philippines: a retrospective study. Eur Stroke J. 2023;8(2):586.

Prado M, Jamora RD, Charmaine Sy M, Anlacan M, Espiritu A. Determinants and Outcomes of Cerebrovascular Disease in Patients with COVID19 in the Philippines: An Analysis of 10881 Cases. Neurology. 2022;98(18). https://doi.org/10.1212/WNL.98.18_supplement.2076 .

Qua CV, Tiqui V, Villatima NE, Perales DJ, Rubio SM, Santos ER, et al. A predictive assessment of early neurological deterioration among Filipino acute ischemic stroke patients utilizing hematological, lipid profile, and metabolic parameters in a tertiary hospital in Pampanga. Philippines Cerebrovasc Dis. 2022;51:101.

Que DL, Cuanang J, San Jose MC. Clinical profile, management and outcomes of patients with cerebralvenous thrombosis in atertiary hospital in the Philippines. Int J Stroke. 2020;15(1):511.

Quiles LEP, Diamante PAB, Pascual JLV. Impact of the COVID-19 pandemic in the acute stroke admissions and outcomes in a Philippine Tertiary Hospital. Cerebrovasc Dis Extra. 2022;12(2):76–84.

Roxas AA. The RIFASAF project: a case-control study on risk factors for stroke among Filipinos. Philippine J Neurol. 2002;6(1):1–7.

Roxas AAC, Carabal-Handumon J. Knowledge and perceptions among the barangay health workers in Plaridel, Misamis Occidental. Philipp J Neurol. 2002;6(1):44.

Sasikumar S, Bengzon Diestro JD. Global & community health: acute ischemic stroke in Toronto and Manila: bridging the gap. Neurology. 2020;95(13):604–6.

Senga MM, Reyes JPB. Cerebral venous thrombosis in a single center tertiary hospital of a South East Asian country (CVSTS study)-a retrospective study on the clinical profiles of patients with cerebral venous thrombosis. Neurology. 2019;92(15). https://doi.org/10.1212/WNL.92.15_supplement.P5.3-011 .

Sese LVC, Guillermo MCL. Strengthening stroke prevention and awareness in the Philippines: a conceptual framework. Front Neurol. 2023;14:1258821.

Suwanwela NC, Chen CLH, Lee CF, Young SH, Tay SS, Umapathi T, et al. Effect of combined treatment with MLC601 (NeuroAiDTM) and rehabilitation on post-stroke recovery: the CHIMES and CHIMES-E studies. Cerebrovasc Dis. 2018;46(1–2):82–8.

Talamera AF, Franco DS. Validation study of Siriraj stroke score in Southern Philippines. Cerebrovasc Dis. 2011;32:9.

Tan A, Navarro J. Outcomes and quality of care outcome of patients with primary intracerebral hemorrhage in a single center in the philippines. Int J Stroke. 2014;9:269.

Tangcuangco NC, Bitanga ES, Roxas AA, Pascual JL, Saniel E, Reyes JP, et al. Intravenous recombinant tissue plasminogen activator (IV-rtPA) use in acute ischemic stroke in a private tertiary hospital: a Philippine setting. Int J Stroke. 2010;5:107.

Tsang ACO, Yang IH, Orru E, Nguyen QA, Pamatmat RV, Medhi G, et al. Overview of endovascular thrombectomy accessibility gap for acute ischemic stroke in Asia: a multi-national survey. Int J Stroke. 2020;15(5):516–20.

Vatanagul J, Cantero-Auguis C. Awareness on acute stroke management among family medicine and internal medicine residents in Metro Cebu. Philippines J Neurol Sci. 2015;357:e418–9.

Vatanagul J, Rulona IA. The incidence of post-stroke depression in a tertiary hospital in Cebu City, Philippines. J Neurol Sci. 2015;357:e419.

Vatanagul JAS, Rulona IA, Belonguel NJ. Cerebral venous thrombosis (CVST): study of four Filipino patients and literature review. Cerebrovasc Dis. 2013;36:81.

Venketasubramanian N, Yoon BW, Pandian J, Navarro JC. Stroke epidemiology in south, east, and south-east Asia: a review. J Stroke. 2017;19(3):286–94.

Yu RF, San Jose MC, Manzanilla BM, Oris MY, Gan R. Sources and reasons for delays in the care of acute stroke patients. J Neurol Sci. 2002;199(1–2):49–54.

Philippine Neurological Association One Database - Stroke DsSMG. Multicentre collection of uniform data on patients hospitalised for transient ischaemic attack or stroke in the Philippines: the Philippine Neurological Association One Database-Stroke (PNA1DB-Stroke) protocol. BMJ Open. 2022;12(5):54.

Feigin VL, Owolabi MO, Group WSOLNCSC. Pragmatic solutions to reduce the global burden of stroke: a world stroke organization-lancet neurology commission. Lancet Neurol. 2023;22(12):1160–206.

Download references

Acknowledgements

We acknowledge the TULAY collaborators: Dr Roy Francis Navea, Dr Myrna Estrada, Dr Elda Grace Anota, Dr Maria Mercedes Barba, Dr June Ann De Vera, Dr Maria Elena Tan, Dr Sarah Buckingham and Professor Fiona Jones. We are grateful to Lance de Jesus and Dr Annah Teves, Research Assistants on the TULAY project, for their contribution to some of the data extraction.

This research was funded by the NIHR Global Health Policy and Systems Research Programme (Award ID: NIHR150244) in association with UK aid from the UK Government to support global health research. The views expressed in this publication are those of the authors and not necessarily those of the NIHR or the UK’s Department of Health and Social Care.

Author information

Authors and affiliations.

Faculty of Health, Intercity Place, University of Plymouth, Plymouth, Devon, PL4 6AB, UK

Angela Logan, Bridie Kent, Aira Ong & Jonathan Marsden

Royal Devon University Healthcare NHS Foundation Trust, William Wright House, Barrack Road, Exeter, Devon, EX2 5DW, UK

Angela Logan

De La Salle University-Evelyn D. Ang Institute of Biomedical Engineering and Health Technologies, 2401 Taft Avenue, Malate, Manila, 1004, Philippines

Lorraine Faeldon

The University of Plymouth Centre for Innovations in Health and Social Care: A JBI Centre of Excellence, Faculty of Health, Intercity Place, University of Plymouth, Plymouth, Devon, PL4 6AB, UK

Bridie Kent

You can also search for this author in PubMed   Google Scholar

Contributions

Conceptualisation, methodology and setting search terms, AL, LF, AO, JM, BK. Searches and screening, AL, JM, LF, AO. Data extraction, AL, LF, AO, JM, LdJ, AT. Original draft preparation, AL, JM. All authors provided substantive intellectual and editorial revisions and approved the final manuscript.

Corresponding author

Correspondence to Angela Logan .

Ethics declarations

Ethics approval and consent to participate, consent for publication, competing interests.

The authors declare no competing interests.

Additional information

Publisher’s note.

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Supplementary Information

Supplementary material 1., rights and permissions.

Open Access This article is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License, which permits any non-commercial use, sharing, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if you modified the licensed material. You do not have permission under this licence to share adapted material derived from this article or parts of it. The images or other third party material in this article are included in the article’s Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article’s Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by-nc-nd/4.0/ .

Reprints and permissions

About this article

Cite this article.

Logan, A., Faeldon, L., Kent, B. et al. A scoping review of stroke services within the Philippines. BMC Health Serv Res 24 , 1006 (2024). https://doi.org/10.1186/s12913-024-11334-z

Download citation

Received : 20 March 2024

Accepted : 22 July 2024

Published : 30 August 2024

DOI : https://doi.org/10.1186/s12913-024-11334-z

Share this article

Anyone you share the following link with will be able to read this content:

Sorry, a shareable link is not currently available for this article.

Provided by the Springer Nature SharedIt content-sharing initiative

• Stroke care
• Low- middle-income countries
• Developing countries
• Philippines

BMC Health Services Research

ISSN: 1472-6963

• General enquiries: [email protected]

An official website of the United States government

The .gov means it’s official. Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

The site is secure. The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

• Publications
• Account settings

Preview improvements coming to the PMC website in October 2024. Learn More or Try it out now .

• Advanced Search
• Journal List
• Front Public Health
• PMC11363875

Relevant factors affecting nurse staffing: a qualitative study from the perspective of nursing managers

1 Department of Nursing, Jinan University, Guangzhou, China

2 Department of Nursing, Guangdong Provincial People’s Hospital (Guangdong Academy of Medical Sciences), Southern Medical University, Guangzhou, China

3 Department of Nursing, Guangdong Pharmaceutical University, Guangzhou, China

Jiangfeng Pu

Zhanghao xie.

4 Department of Nursing, Shantou University Medical College, Shantou, China

Tiemei Shen

Huigen huang.

Su-I Hou, University of Central Florida, United States

Associated Data

The original contributions presented in the study are included in the article/supplementary material, further inquiries can be directed to the corresponding author.

To understand the current situation of nursing manpower allocation, explore the factors affecting nurse staffing, improve nurse staffing level, and provide reference for better formulation of nursing human resources staffing standards.

A descriptive research method was used to conduct semi-structured interviews with 14 nursing managers. The data were analyzed and refined by content analysis. The sample size was subject to content saturation.

Nine themes and twenty sub-themes of influencing factors for nursing staffing were identified across four levels: hospital level, department level, patient level, and nurse level.

Hospital and department managers need to comprehensively consider the factors of affecting nurse staffing. Adopting multidimensional optimization measures, improving relevant systems, optimizing nurse structure, and establishing flexible and mobile nurse database to cope with public emergencies, so as to effectively improve nurse staffing and nursing service quality.

1. Introduction

The global nursing workforce shortage has been a major challenge in the medical field. In 2020, the World Health Organization reported a shortage of 5.7 million nurses and midwives ( 1 ). By the end of 2022, the total number of health workers in China was 14.411 million. Among them, the total number of registered nurses is 5.224 million ( 2 ). Compared with the 2025 China nursing career planning target, there is still a gap of 276,000 ( 3 ). The number of registered nurses in China in 2022 is 3.17 per 1,000 population, which is far lower than the global median density proposed by WHO (4.86 per 1,000 population) ( 4 ). In the evolving healthcare sector, ensuring optimal nurse staffing remains a key issue in hospital administration and nursing management ( 5 , 6 ). Adequate nurse staffing is critical not only to provide high quality patient care, but also to maintain nurse job satisfaction and reduce turnover ( 7 , 8 ). However, the factors that influence nurse staffing are multifaceted and complex, including a range of variables from institutional policies to the characteristics of individual nurses. At present, researchers mainly focus on quantitative studies on nurse staffing and nursing quality, patient outcomes and nurse outcomes ( 9 , 10 ). However, there are few qualitative studies on the influencing factors of nurse staffing. Nursing managers play a key role in staffing decisions, pay close attention to day-to-day operational dynamics and challenges, and are uniquely positioned to provide insights into the various factors that affect nurse staffing ( 11 ). Therefore, this study aims to explore the influencing factors of nurse staffing through the perspective of nursing managers, and through in-depth interviews and thematic analysis, reveal the human resource challenges and considerations faced by nursing managers in their efforts to ensure appropriate nurse staffing levels. The results of this study will help develop more effective staffing strategies and policies, ultimately improving the quality of care provided to patients and improving the working environment for nurses.

2. Research objectives

This qualitative study explores the influencing factors of nurse staffing. Two nursing managers were selected for pre-interview, and the final interview outline was revised according to the feedback of the pre-interview. See Table 1 for details.

Interview outline.

3. Materials and methods

3.1. participant recruitment.

From December 2023 to February 2024, nursing managers in a Grade 3 hospital in Guangdong Province were selected as interview subjects by purpose sampling method. Inclusion criteria: (a) Engaged in clinical work ≥10 years; (b) Engaged in management work ≥3 years; (c) have intermediate or above professional titles; (d) Informed consent and voluntary participation in this study.

3.2. Data collection methods

The development of the interview outline was based on the research objectives and a review of relevant literature, following a systematic process ( 12 ). An initial draft of the interview guide was formulated to focus on the research theme. This draft was refined through discussions in project team meetings. Before the formal interviews, two nursing managers were invited to participate in pilot interviews, and since no further revisions were needed, the pilot interview data were included in the subsequent analysis. The qualitative research involved conducting semi-structured, in-depth face-to-face interviews with the participants. Before each interview, one researcher (LGG) obtained informed consent from the interviewees, explaining the purpose, methods, and content of the interview. The interviews were recorded and noted, and were conducted in the interviewee’s office to ensure privacy. To protect the confidentiality of the participants, two researchers (LGG and WWE) were responsible for questioning and recording, respectively, using pseudonyms N1 to N14 instead of real names. The interviews were conducted in easily understandable language, encouraging participants to express their feelings and thoughts fully. Active listening, clarification, and probing techniques were employed, along with noting non-verbal cues. Each interview lasted between 30 and 60 min, with an average duration of 39 min.

3.3. Data analysis methods

Data collection and analysis in this study were conducted simultaneously. Within 48 h after each interview, the recordings were transcribed verbatim, and the non-verbal information recorded during the interviews was integrated into the documents, forming complete interview transcripts. We used thematic analysis to analyze the data ( 13 ), organizing the materials with NVivo Plus 11 software. Throughout the analysis process, the two researchers (LGG and WWE) maintained an open and neutral attitude, repeatedly reading the transcripts and non-verbal notes. By continuously comparing and inductively analyzing the data, we extracted themes to gain a deeper understanding of the participants’ actual meanings. Text from individual interviews was divided into meaning units that were condensed and coded. The themes in the table were derived from the initial codes, with similar codes grouped into subcategories and categories, which were then further organized into themes ( 14 ). The first author identified the initial codes, while the other authors reviewed the coded interview samples. Any disagreements regarding themes were resolved through discussions among all authors until a consensus was reached.

4.1. Sample size

The sample size was by information saturation ( 15 ). Finally, a total of 14 participants participated in this study, among which 13 were female and 1 was male, and the average age of all participants was 45.86 years old (33 ~ 52 years old). The average duration of clinical work was 25.57 years (11–23 years) and the average duration of managerial work was 11.21 years (4–16 years). The demographic characteristics of participants are shown in Table 2 .

General data sheet for participants.

4.2. Hospital level

4.2.1. imperfect policies and systems.

Decisions made by hospital management based on national policies, such as establishing standards for bed-to-nurse ratios in each department, inspection systems, training and promotion mechanisms, significantly impact nurse allocation. However, N12 highlights that for specialized departments like emergency care, there lacks a unified allocation standard in China ( 16 ), which complicates nurse allocation levels to some extent. Several respondents in the study noted limitations in current nurse staffing due to rigid adherence to bed-to-nurse ratios that often fall short, thereby compromising adequate staffing levels. Furthermore, the imperfect inspection, promotion, and training systems in the face of a complex and evolving clinical environment constrain nurses’ workload and career advancement opportunities, affecting both stability and quality of nursing care.

4.2.2. Insufficient manpower reserve

The hospital’s human resource reserve directly influences the quantity and quality of nurses, as well as the hospital’s capacity to address staffing shortages, temporary needs, and emergencies. Respondents in the study also noted that due to insufficient or lacking hospital manpower reserves, even submitted personnel demand applications often remain unresolved.

4.3. Department level

4.3.1. department characteristics.

In the rational allocation of nursing human resources, it is necessary to consider a variety of factors, such as the department’s patient conditions, department size, bed turnover, workload, and the need for specialized nursing. For instance, departments like emergency, intensive care, and surgery require nurses with specific professional skills and knowledge to ensure patient safety and effective treatment outcomes.

4.3.2. Cost-effectiveness driven nurse staffing

Reasonable manpower cost control can be in to ensure the quality of care under the premise of optimizing the allocation of resources, improve the efficiency of the cost. Appropriate labor cost control of department, fair and reasonable scheduling system, by ensuring reasonable salary, meet the demand of nurses reasonable help stabilize the nurse team, reduce turnover and maintain the continuity and stability of the nursing work, at the same time maximize the cost-effectiveness of department, ensure quality of nursing service.

4.3.3. Cultural construction of the department

Department culture construction is one of the important factors affecting the allocation of nurses, including good working atmosphere and teamwork, effective communication and mutual understanding, and staff care. A good department culture construction can improve the satisfaction and stability of nurses, and ensure the efficiency and high quality of nursing work. In the study, respondent N1 also said that a good working atmosphere in the department would alleviate the original shortage of manpower.

4.3.4. Multi-level recognition and support

Nurses occupy a large proportion in the department and play an indispensable role. Recognition at the department level, including but not limited to the head nurse and department director, as well as the recognition and support from doctors for the work of nurses, can not only enhance nurses’ job satisfaction and loyalty but also significantly improve the efficiency and quality of nursing care. This influence helps optimize working conditions for nurses.

4.4. Patient level

4.4.1. patient profile.

With the rapid development of social economy, the demand for nursing services is gradually increasing. The basic situation of patients, including the number of patients, the complexity of the disease, the self-care ability of patients and the patient’s needs, which will virtually affect the workload of nurses, and therefore put forward requirements for the staffing of nurses.

4.5. Nurse level

4.5.1. challenges in nursing human resources.

The shortage of nurses is a significant issue in nursing human resource management, profoundly affecting nurse staffing. Insufficient nursing staff can lead to a decline in the quality of nursing services, failing to meet patient care needs, and thereby impacting treatment outcomes and patient satisfaction. Respondents to the study indicated that this shortage is expected to persist in the short term. Currently, nurses face high workloads and pressure, with long-term overwork increasing their physical and psychological burden, reducing work efficiency and quality, and leading to higher turnover rates. This exacerbates the challenges in nurse staffing.

4.5.2. Nursing professional development

The structure of nurses is an important part of human resource management, including the age, work experience, title, comprehensive ability and specialized skills of nurses. Optimizing the structure of nurses can promote the staffing of nurses. Provide continuous professional training and career development opportunities for the nursing team, including advanced studies, promotions, and specialized training. These initiatives will improve nurses’ professional skills and career satisfaction, enhancing their willingness to stay in the department and their overall stability (see Table 3 ).

Influencing factors of nursing staffing.

5. Discussion

For additional requirements for specific article types and further information please refer to “Article types” on every Frontiers journal page. From the perspective of nursing managers, this study discussed the relevant factors affecting nurse staffing, mainly from four levels: hospital, department, patient and nurse level.

The results of this study indicate that nurse staffing is related to the imperfection of hospital policies and systems, the lack or insufficiency of manpower reserves, and the control of nurse manpower costs. The formulation of policies related to nursing human resources can play a crucial role in the number of nurses. On the one hand, although China has formulated many standards, principles and plans for staffing ( 17–20 ), but at present, most medical institutions in our country still adopt a single number of beds for human staffing, ignoring the differences of condition, disease, service quantity, etc., which makes it difficult to meet the clinical practical needs of nursing human resources. On the other hand, the participants indicated that the hospital did not reserve talents or had insufficient reserves at present, and the study found that public emergencies would have a certain impact on the staffing of nurses, and the reasonable establishment of a mobile nurse base could make up for the shortage of manpower to a large extent in crisis situations ( 21 ).

At present, there is no legislation on nurse staffing in China, but there are a few areas ( 10 , 22 , 23 ), such as Victoria or Queensland in Australia and California in the United States, have made the nurse–patient ratio mandatory, and scientifically found that this measure is beneficial to patients and healthcare systems. Belgium is also reforming its nursing staffing policy and using part of its budget to hire non-nursing staff to alleviate the shortage of nurses, while India is making further efforts to revise the standards of the nurse-to-patient ratio. Yet labor costs dominate hospital budgets. They are easy targets for cuts to offset other expenses ( 24 ). The financial budget of a hospital on the cost of nursing manpower will directly affect the number of nurses, resulting in the imbalance of the nurse-to-patient ratio, and increasing the work pressure and load of existing nurses ( 25 ). In the future, when developing safe and reasonable nurse staffing, it is necessary to comprehensively consider the control of nurse labor cost and solve the problem of baseline nurse staffing, so as to better cope with the fluctuation of nurse nursing demand among patients ( 26 , 27 ).

In addition, the shortage of manpower reserve makes it difficult for hospitals to quickly deploy enough nurses in the face of emergencies (such as epidemics, natural disasters, etc.), which affects the timeliness and effectiveness of nursing work. First of all, in order to actively and effectively respond to public emergencies and other emergency events, it is necessary to establish a mobile nurse team. At the same time, it is necessary to strengthen the hospital’s leadership of the nurse team and improve the emergency level of the nurse team. Secondly, the recruitment process of new nurses should be accelerated, and the relevant training mechanism should be optimized to ensure that new nurses can quickly get on the job and adapt to the work needs. Finally, establish reasonable vacation and prepare class arrangements, to ensure that the nurse has enough during the period of vacation or sick leave substitute nurses to fill the gap, to ensure the safety of patients and the high quality nursing service.

The results of this study show that the staffing of nurses is related to the department characteristics, cost-effectiveness driven nurse staffing, department culture construction and multi-level recognition and support. Nurses with affected by the characteristics of the various specialist departments for college work, care needs and technical differences, nurse need to change accordingly, in order to ensure safe and effective nursing service. The control of nurse labor costs varies between departments and hospitals due to differing economic benefits. It is crucial to balance the relationship between existing nurse staffing and costs. A limited department budget can affect the hiring of additional nurses or the ability to increase nurses’ salaries, directly impacting nurse staffing levels. Implementing a fair and reasonable scheduling system ensures that each nurse receives adequate work and rest time, preventing overwork or underwork. This can improve job satisfaction and work efficiency, thereby reducing nurse turnover rates and fatigue ( 28 ).

Additionally, fostering a positive departmental culture is also essential. Nurses’ working environment and atmosphere, and leadership style can affect nurses’ turnover intention, thus further affecting the staffing level of nurses and the quality of nursing work by affecting nurses’ turnover intention ( 29–31 ). Active teamwork, effective communication, and mutual understanding are crucial factors in optimizing nurse allocation and improving the quality of nursing services. Good teamwork and effective communication streamline workflow, reduce redundant tasks and communication errors, and enhance nursing efficiency ( 32 , 33 ). Mutual understanding and trust among team members facilitate knowledge and experience sharing, promoting both individual and team skill development. A well-functioning department resembles a warm, supportive family, which requires managers to show concern and care for nurses, focusing on their physical and mental health needs. This helps alleviate work pressure, strengthens colleague relationships, and enhances team stability. Multi-level recognition and support from department directors, head nurses, doctors, and patients serve as key motivators for nurses, reinforcing their commitment and sense of value in their work. However, the lack of necessary material and emotional support increases job burnout and affects nurses’ intention to stay ( 34 , 35 ). Therefore, in this challenging environment, it is crucial to optimize nurse allocation, enhance the quality of care, and ensure the stability of the nursing team. This can be achieved by improving the working environment and atmosphere, fostering team cooperation, formulating reasonable scheduling plans, and establishing effective communication and feedback mechanisms.

With the accelerated aging of China’s population and the increasing prevalence of chronic diseases, the demand for long-term care and health management has risen significantly. The growing number of patients directly impacts the number of nursing staff needed in departments. A high patient load necessitates more nursing staff to ensure each patient receives adequate care. This situation poses a challenge for managers in nursing staff allocation, requiring flexible adjustments based on patient admissions and discharges to respond to fluctuating peaks and troughs.

Patients with complex conditions require higher levels of nursing skills and more hours of care, necessitating additional specialized nursing staff or more training and support. As patients’ expectations for the quality of nursing care rise, departments need to increase their nursing staff to meet these expectations. A higher level of nursing expertise can improve patient satisfaction, delivering higher quality care and greater value ( 36 ). Therefore, when planning nurse allocation, managers should consider the number of patients, the complexity of conditions, and specific nursing needs. By conducting thorough evaluations and making flexible adjustments to the nursing team, managers can effectively address the needs of different patient groups and enhance the quality and efficiency of nursing services.

Nurses are the largest group in the medical and health system, occupying an irreplaceable position, and sufficient nursing staff is the premise and basis of rational allocation of nursing human resources. The shortage of nurses is a serious problem facing the world today ( 37 , 38 ). The shortage of nurses will lead to the increase of nursing workload and labor intensity, resulting in a high turnover rate of nurses, and turnover intention is a predictive factor of turnover rate ( 39 , 40 ). The turnover intention of nurses varies significantly among different countries. The turnover intention of nurses in South Korea was 18.8% ( 41 ), 22.5% of nurses in European countries expressed their intention to quit ( 42 ) and 43% of nurses in Lebanon expressed an intention to leave within one year ( 43 ). In China, the turnover intention of nurses in East China is 43% ( 44 ) and that of nurses in Guangdong Province is as high as 64.1% ( 40 ), which means that the turnover rate of nurses in China remains high, and the gap of nurses will further increase. Attracting and retaining the existing nurse workforce is critical to maintaining high quality patient care ( 26 ). Studies have shown that nurses are the foundation of patient safety and nursing quality, and higher nurses’ satisfaction will bring better job performance, nursing quality and employee retention ( 34 , 45 ). In addition, research shows that with adequate nurse staffing, good working environment and welfare benefits, nurses will have higher job satisfaction and lower turnover intention, thus ensuring the stability of the nurse team and nursing quality ( 46 ). With the continuous improvement of medical technology, higher requirements are put forward for the education level and working ability of nurses. Nurses need to constantly enrich their theoretical knowledge and improve their nursing skills in order to meet the growing nursing needs and the speed of high-quality development of hospitals. Therefore, the nurse structure should be considered and further optimized when staffing nurses.

5.1. Limitations

The study has several limitations. First of all, in order to ensure the diversity of the study subjects, we used purpose sampling to sample the head nurses of various departments in the hospital, but the study scope was limited to one hospital, which made it difficult to obtain additional information. Secondly, the interview document data is translated from Chinese to English, and there is a certain risk of translation errors.

6. Conclusion

From the perspective of nursing managers, this study explores the related factors affecting the allocation of nurses through descriptive qualitative research, explores the specific challenges, pressures and needs of nurses in their work, and reveals the deep causes of the shortage of nurses from multiple levels and directions, rather than just stay on the quantity and statistical data. From a nursing manager’s perspective, the results of this qualitative study highlight the multifaceted and interrelated factors that influence nurse staffing. Hospital-level factors are the most critical. Improving and unifying nursing personnel staffing standards is the premise of ensuring the development of high-quality nursing. Nursing managers stressed the importance of a supportive work environment, effective communication, and continuing professional development to mitigate staffing challenges. At the same time, it reveals the influence of humanistic and emotional factors, and captures the importance of humanistic care, emotional support and professional identity experienced by nurses in the work. These factors have an important impact on the job satisfaction and retention rate of nurses, thereby indirectly affecting the staffing of nurses. Addressing these factors through integrated strategies can improve nurse retention, improve the quality of patient care, and foster a more stable and satisfied nursing workforce. This study can provide deep insight and effective strategy suggestions for understanding and solving today’s nurse staffing problems, so as to provide a unique contribution to the continuous development and improvement of the nursing profession.

Data availability statement

Ethics statement.

The studies involving humans were approved by Ethics Review Committee of Guangdong Provincial People’s Hospital. The studies were conducted in accordance with the local legislation and institutional requirements. The participants provided their written informed consent to participate in this study. Written informed consent was obtained from the individual(s) for the publication of any potentially identifiable images or data included in this article.

Author contributions

GL: Conceptualization, Data curation, Formal analysis, Investigation, Visualization, Writing – original draft, Writing – review & editing. WW: Conceptualization, Data curation, Formal analysis, Investigation, Writing – review & editing. JP: Conceptualization, Data curation, Writing – review & editing. ZX: Supervision, Writing – review & editing. YX: Methodology, Supervision, Writing – review & editing. TS: Methodology, Project administration, Supervision, Writing – review & editing. HH: Supervision, Writing – review & editing, Funding acquisition, Resources.

Acknowledgments

The authors would like to express their sincere gratitude to all the people who participated.

Funding Statement

The author(s) declare that financial support was received for the research, authorship, and/or publication of this article. This study was supported by the Nursing Research sub-project of China Health Personnel Training Program (Project number: RCLX2320048).

Conflict of interest

The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.

Publisher’s note

All claims expressed in this article are solely those of the authors and do not necessarily represent those of their affiliated organizations, or those of the publisher, the editors and the reviewers. Any product that may be evaluated in this article, or claim that may be made by its manufacturer, is not guaranteed or endorsed by the publisher.