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AnteayerJournal of Nursing Scholarship

A Framework Analysis of Thematic Correspondence Between the GNWC Research Question Framework and the WHO State of the World's Nursing 2025 Report

ABSTRACT

Introduction

The Centre was established in March 2025 as a central repository to document the gaps in nursing workforce data needed to inform planning and policy development. To establish research priorities, an inaugural panel of Centre experts created 98 initial research questions (GNWC) across five domains: education, practice, regulation, policy, and systemic issues. Released in May 2025, the World Health Organization's (WHO) State of the World's Nursing 2025 (SOWN) provides updated worldwide nursing workforce data and global analysis. This study explores GNWC framework alignment with topics addressed in SOWN to affirm its direction and to augment research areas that are underrepresented.

Design

A framework analysis was conducted to compare SOWN findings with the GNWC research question framework. Findings between the two reports were categorized to identify areas of convergence and divergence.

Methods

Thematic information was extracted from SOWN, and each GNWC question was examined in relation to the extracted information. Data were grouped by topic into five domains and classified according to thematic congruence. An iterative process was used to capture the consensus on alignment reached between the researcher and the panel of experts.

Results

Varied thematic congruence was identified between SOWN and the five domains of the GNWC framework: Education, Practice, Regulation, Policy, and Systemic issues. Shared understandings of global challenges were evident in all domains, with both minor and major differences identified.

Conclusion

The analysis demonstrates substantial thematic congruence between the GNWC research question framework and SOWN across several domains. Areas of more limited coverage include Education and Systemic issues.

Clinical Relevance

Identifying challenges and evidence gaps in the global nursing workforce helps set research priorities and develop evidence-based strategies to strengthen it, thereby improving patient access to care and health outcomes.

Spirituality Among Older Adults With Depression: An Interpretative Phenomenological Study

ABSTRACT

Introduction

Spirituality is a crucial yet complex element of holistic nursing care, particularly when providing care for older adults with depression. In Thailand, depression poses a significant mental health challenge. Thai cultural values are deeply interwoven with individuals' beliefs, making spirituality a critical factor in addressing the care of older adults with depression. This study aimed to explore how older adults with depression experience spirituality and construct meaning from it in their daily lives.

Design

An interpretative phenomenological study.

Methods

In-depth interviews of 30 older Thai adults living with depression (aged 60–85 years) from an outpatient psychiatric clinic in southern Thailand were conducted using semi-structured interview questionnaires. Interpretive phenomenological analysis was employed. Data were collected from June to August 2024.

Results

Five themes emerged from the phenomenological data analysis: (1) elusiveness of spiritual meaning, (2) holding oneself together through inner power, (3) finding acceptance through faith in a higher power, (4) family ties shaping peace and despair, and (5) being guided and cared for.

Conclusion

This study highlights that older adults with depression perceive spirituality as essential for their well-being. Personal practices, such as meditation and chanting, played a key role in strengthening spirituality and reducing the risk of relapse in depressive symptoms, which are distinct for each older adult. Understanding spirituality's role in mental health guides nurses to develop strategies for providing more empathetic spiritual care.

Clinical Relevance

Nurses must address depression in older adults through individualized practices to effectively empower their inner strength and coping mechanisms. Understanding each individual's spiritual practices is essential to help them harness their inner strength when coping with depression.

Social Determinants of Health and Falls Among Community‐Dwelling Older Adults: A Zero‐Inflated Negative Binomial Regression Analysis

ABSTRACT

Introduction

Falls among older adults represent a major public health challenge, yet research examining the role of social determinants of health (SDOH) in fall risk remains limited. This study aimed to identify factors associated with fall occurrence and fall frequency among community-dwelling older adults in Korea, with particular emphasis on SDOH.

Design

A cross-sectional study design.

Methods

We used a large nationwide sample (n = 9746) from the 2023 National Survey of Older Koreans. The number of falls in the past year served as the dependent variable. Independent variables included a range of socioeconomic and environmental variables as SDOH, alongside biological and behavioral variables. A zero-inflated negative binomial (ZINB) regression analysis was employed to address excess zeros and overdispersion in fall count data.

Results

Among participants, 94.8% experienced no falls, 3.2% reported a single fall, and 1.9% reported recurrent falls. In the logit model for fall occurrence, higher household income level, absence of age-friendly housing, higher access to parks, and lower access to welfare centers were associated with higher risk of fall occurrence. In the count model for fall frequency, higher education level, presence of age-friendly housing, and outdoor mobility barriers were associated with higher fall frequency within the at-risk group.

Conclusions

The findings provide empirical evidence on the critical roles of SDOH in falls among community-dwelling older adults. Specifically, a ZINB regression analysis identified distinct sets of SDOH associated with fall occurrence versus fall frequency, highlighting the complex and multifaceted nature of fall patterns among older adults.

Clinical Relevance

Healthcare providers and policymakers seeking to reduce falls should implement tailored, SDOH-integrated strategies by addressing the different mechanisms underlying fall occurrence and fall frequency.

Lived Experiences of Transgender Inmates in Barcelona Prisons: An Interpretative Phenomenological Study

ABSTRACT

Introduction

Incarceration significantly impacts inmates health, particularly marginalized groups like transgender persons, due to systemic oppression and inadequate healthcare. This study aims to understand transgender prisoners' health management experiences.

Methodology

An interpretative phenomenological approach was used. Data were collected through in-depth interviews with eight transgender inmates in Barcelona, Spain, and analyzed using the seven-step Colaizzi method.

Results

Three primary themes emerged: (1) Navigating Vulnerability in Healthcare Dynamics, which highlighted experiences of stigma and inadequate care; (2) The Quest for Wellbeing Amidst Uncertainty, underscoring concerns regarding treatment continuity; and (3) Negotiating a Landscape of Violence, revealing experiences of harassment and discrimination.

Discussion

This study highlights the need for culturally competent, person-centered healthcare policies in prisons, particularly for transgender individuals. Addressing the specific health needs of transgender inmates is crucial for enhancing their overall well-being. This emphasizes the importance of systemic reforms to improve care provision for transgender prisoners.

Clinical Relevance

Prison nurses must prioritize person-centered approaches, ensure continuity of gender-affirming treatments, and provide empathetic mental health support to enhance trust and improve the overall well-being of transgender inmates.

Barriers to and Facilitators of Shared Decision‐Making Implementation in Fertility Preservation for Patients With Cancer: A Qualitative Study

ABSTRACT

Introduction

To identify the barriers and facilitators in the implementation of fertility preservation (FP) shared decision-making (SDM) in oncology care.

Design

Qualitative descriptive study.

Methods

Qualitative interviews with 16 female patients with cancer and seven healthcare providers were conducted between July 2022 and April 2024. Data were analyzed using directed content analysis, guided by the implementation science framework.

Results

We identified 22 categories comprising 38 codes as barriers to SDM implementation and 17 categories comprising 26 codes as facilitators. Findings revealed that, at the innovation level, accessibility, feasibility, interdisciplinary collaboration, and quality improvement efforts were decisive in the implementation of FP SDM. At the individual level, healthcare providers' awareness and attitudes towards FP and SDM, as well as patients' knowledge, attitudes, and capabilities in FP SDM, were crucial factors in the implementation of FP SDM. In social, economic, and organizational contexts, support from significant others, social awareness about FP, multidisciplinary care, financial assistance, and educational resources were determinants in implementing FP SDM.

Conclusion

Implementing FP SDM among female patients with cancer necessitates a strategic approach that considers barriers and facilitators. Educating and promoting FP SDM among the public and healthcare providers, combined with incentivizing policies, can enhance individual knowledge and awareness while achieving systemic improvements, facilitating its successful implementation.

Clinical Relevance

This study provides insights into barriers and facilitators and proposes strategic approaches to enhancing FP SDM implementation, contributing to improved quality of life for cancer survivors and advancements in clinical practice.

Effectiveness of a Tailored Psychoeducational Intervention for Patients With Advanced Cancer in Indonesia: A Randomized Controlled Trial

ABSTRACT

Background

Patients with advanced cancer often face numerous physical, psychological, and practical challenges from their disease and treatments, yet interventions addressing their specific unmet needs remain limited.

Purpose

This study aimed to evaluate the effectiveness of a tailored psychoeducational intervention (PEI) on stress, anxiety, depression, coping, and fatigue among advanced cancer patients in Indonesia.

Design

A randomized controlled trial was conducted from August 2022 to March 2023 in Indonesia.

Methods

A total of 151 advanced cancer patients from a referral hospital in Indonesia were randomized into intervention and control (conventional management) groups. Participants were assessed using validated questionnaires including the Depression, Anxiety, and Stress Scale (DASS-21), Fatigue Severity Scale (FSS), and Brief COPE at three time points: baseline (T0, before intervention), after first intervention (T1), and after second intervention (T2). The PEI was delivered face-to-face with telephone follow-up calls. Generalized Estimating Equations (GEE) analysis was used to evaluate the intervention's effectiveness.

Results

The intervention was significantly associated with improved coping and reduced fatigue scores. Significant time effects were observed for depression, stress, coping, and fatigue scores. For anxiety, a significant impact was found at the second time point but not at the third, compared to the baseline. The difference-in-difference (DID) analysis revealed significant effects on coping and fatigue scores, while anxiety only showed significance at the second time point.

Conclusions

This study provides evidence for the potential effectiveness of PEI in improving coping strategies, relieving stress, anxiety, and depression, and reducing fatigue among advanced cancer patients in Indonesia.

Clinical Relevance

The tailored PEI, including follow-up phone calls, can be independently implemented by nurses. Focusing on patients' unmet needs and spirituality, this intervention can help manage mental health issues and strengthen coping mechanisms, potentially leading to positive effects on physical conditions such as fatigue.

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