Nursing Practice Today

Cross-cultural adaptation and psychometric refinement of the Thai Work-Related Stress Questionnaire (T-WRSQ) for registered nurses

Vachira Posai — 2026-09-26

Background & Aim: Work-related stress can adversely affect nurses’ well-being, workforce stability, and quality of care. However, a culturally appropriate and psychometrically validated instrument for assessing psychosocial work-related stress among Thai nurses is needed. This study aimed to translate, culturally adapt, and psychometrically refine the Work-Related Stress Questionnaire (WRSQ) for Thai registered nurses.
Methods & Materials: This two-phase methodological study translated and culturally adapted the WRSQ following international guidelines. The instrument was evaluated by five experts and pilot-tested with 30 nurses. Psychometric evaluation was conducted among 276 registered nurses from Ministry of Public Health hospitals, randomly allocated to exploratory and confirmatory samples. Exploratory factor analysis (EFA) examined factor structure and item performance, followed by confirmatory factor analysis (CFA) of competing models. Convergent validity, discriminant validity, and internal consistency were assessed.
Results: The Thai WRSQ demonstrated excellent content validity (I-CVI and S-CVI/Ave = 1.00). EFA initially identified four factors broadly corresponding to the original WRSQ; however, the Job Demand domain lacked structural coherence. A revised 10-item, three-factor model excluding this domain showed the best CFA fit (χ²/df=1.66, CFI = 0.96, TLI= 0.94, RMSEA= 0.07, SRMR= 0.05). The retained domains demonstrated satisfactory convergent validity (CR= 0.79–0.85; AVE= 0.56–0.66), discriminant validity (AVE>MSV; HTMT= 0.09–0.79), and internal consistency (overall α = 0.82; ω = 0.85).
Conclusions: The revised 10-item Thai WRSQ is a valid and reliable instrument for assessing psychosocial work-related stress among Thai registered nurses.

Sexual health communication in adolescent nursing care: A concept analysis using Walker and Avant's method

Sheraz Khan — 2026-09-26

Background & Aim: Sexual health communication is central to adolescent nursing care, but its meaning remains conceptually inconsistent across nursing settings and adjacent disciplines. This conceptual ambiguity limits assessment, education, measurement, and service design. This study aimed to clarify sexual health communication in adolescent nursing care and identify its defining attributes, antecedents, consequences, and empirical referents.
Methods & Materials: Walker and Avant's eight-step method guided the analysis. CINAHL, PubMed/MEDLINE, Scopus, ERIC, and the Cochrane Library were searched for English-language literature published from January 2000 to December 2025. A focused update through June 2026 used PubMed and backward and forward citation tracking. Full texts were assessed against predefined conceptual and disciplinary eligibility criteria, and data were extracted into a structured matrix. Nursing-specific evidence was prioritized for defining the concept. Thirty substantive sources were included.
Results: Six defining attributes were identified: purposeful initiation and reciprocal adolescent participation; confidentiality enactment and interactional safety; accurate, clear, and developmentally responsive information exchange; responsive relational engagement during the encounter; timely, continuous, and care-linked communication; and contextually responsive and power-aware communication. Antecedents occurred at adolescent, professional, organizational, and sociocultural levels. Potential consequences included enhanced understanding, comfort and disclosure, follow-up, help-seeking, continued communication, and informed decision-making. Broader outcomes, including service access and equitable care, were considered potential distal implications. Existing measures capture selected components but not the complete nurse-adolescent concept.
Conclusion: Sexual health communication in adolescent nursing care is a purposeful, reciprocal, confidentiality-protective, developmentally responsive, and clinically integrated nurse-adolescent interaction. The clarified concept provides a nursing-specific basis for education, clinical assessment, intervention design, and measure development and future validation across diverse cultures and nursing settings.

Behavior change features and techniques in electronic health-supported walking interventions for hypertension: A scoping review

Dwi Esti Handayani — 2026-09-26

Background & Aim: Hypertension remains a major global health challenge associated with cardiovascular morbidity and mortality. Brisk walking is widely recommended as a non-pharmacological strategy for blood pressure control; however, maintaining long-term adherence remains challenging. The integration of electronic health technologies into walking interventions may enhance motivation and behavioral engagement. This scoping review aimed to map digital behavior features and Behavior Change Techniques within eHealth-supported walking interventions for hypertension management.
Methods & Materials: This scoping review followed the Arksey and O’Malley framework and adhered to PRISMA-ScR guidelines. Literature searches were conducted across PubMed, Scopus, ScienceDirect, ProQuest, and Google Scholar for studies published between 2016 and 2025. Eligible studies included adults with hypertension receiving electronic health-supported walking interventions incorporating digital behavior features and/or Behavior Change Techniques. Data were synthesized narratively.
Results: A total of 21 studies were included. Frequently used eHealth technologies included mobile applications, wearable activity trackers, telemonitoring systems, and web-based platforms. Common digital behavior features included step monitoring, reminders, motivational messaging, personalized feedback, coaching support, and gamification. Frequently identified Behavior Change Techniques based on the Behavior Change Technique Taxonomy version 1 included goal setting, self-monitoring, feedback on behavior, prompts/cues, action planning, and social support. Most studies reported improved walking adherence, increased physical activity, enhanced self-management behaviors, and reduced blood pressure.
Conclusion: Electronic health-supported walking interventions demonstrate potential for improving hypertension self-management through integrated digital behavior change strategies. Future studies should emphasize theory-driven intervention design and standardized Behavior Change Technique reporting.

Translation and psychometric evaluation of the Persian version of the Mini-International Classification of Function and disability-rating for limitations of activities and participation in psychological disorders

Fatemeh Ghaedi-Heidari — 2026-09-01

Background & Aim: Patients with mental disorders frequently experience limitations in activity and social participation, potentially disrupting recovery and social reintegration. Accurate assessment of these limitations is essential for treatment planning and rehabilitation. This study aimed to determine the validity and reliability of the Persian version of the Mini-International Classification of Functioning and disability-rating for limitations of activities and participation in psychological disorders.
Methods & Materials: This methodological study was conducted in 2025 among patients discharged from the psychiatric wards. Following forward–backward translation, face and content validity were assessed by 11 experts. Construct validity was evaluated using Exploratory Factor Analysis, followed by Confirmatory Factor Analysis in 193 patients. Reliability was assessed using Cronbach's alpha and the Intraclass Correlation Coefficient.
Results: All items demonstrated satisfactory face and content validity, with no item removed. Content Validity Ratio values ranged from 0.63 to 1.00, while the overall Scale-level Content Validity Index was 0.88, indicating acceptable but slightly below-threshold content validity. Exploratory Factor Analysis identified a three-factor structure explaining 51.13% of the total variance. Confirmatory Factor Analysis showed acceptable model fit. Cronbach's alpha was 0.76 overall, and the Intraclass Correlation Coefficient for the total scale was 0.796, indicating satisfactory internal consistency and stability.
Conclusion: The Persian Mini-International Classification of Function and Disability Rating for limitations of Activities and Participation in Psychological disorders demonstrates acceptable face, content, and three-factor structural validity. However, the low internal consistency of the third factor and suboptimal Tucker–Lewis Index fit warrant caution in interpreting subscale scores.

Developing a conceptual framework for family caregiver preparedness in stroke care: A scoping review

Nor Nadiya Ab Ghani — 2026-09-01

Background & Aim: Family caregivers of stroke survivors often assume complex responsibilities with limited preparation, while evidence on how best to support them remains fragmented. This review aimed to map evidence on family caregiver preparedness in stroke care and use the findings to develop a conceptual framework.
Methods & Materials: A scoping review was conducted using the Joanna Briggs Institute methodology and reported according to guidance for scoping reviews. MEDLINE via Ovid, PubMed, Scopus, ProQuest, and ScienceDirect were searched for peer-reviewed English-language studies published from 2014 to 2025. Quantitative, qualitative, and mixed-methods studies examining preparedness, related frameworks, tools, or interventions were included. Studies involving paid caregivers, paediatric stroke, or psychosocial outcomes without reference to preparedness were excluded. Findings were synthesised descriptively and thematically.
Results: Twenty-two studies met the inclusion criteria. Four examined frameworks, assessment tools, or interventions, and 18 reported preparedness levels and associated factors. Preparedness was generally low to moderate. Three contextual domains shaped caregiving demands: stroke survivor clinical characteristics, caregiving roles and responsibilities, and family caregiver characteristics. Psychosocial and emotional factors and social and supportive resources moderated the relationship between demands and preparedness. These domains were integrated into a framework describing preparedness as a changing balance between caregiving demands and available resources across the stroke care continuum.
Conclusion: Family caregiver preparedness is multidimensional and changes over time. The proposed framework may support assessment, follow-up, and intervention design, but requires empirical and stakeholder validation.